Next Article in Journal
A Review of Methods for Assessing the Environmental Health Impacts of an Agricultural System
Next Article in Special Issue
The Association between Mental Wellbeing, Levels of Harmful Drinking, and Drinking Motivations: A Cross-Sectional Study of the UK Adult Population
Previous Article in Journal
Weather and Suicide: A Decade Analysis in the Five Largest Capital Cities of Colombia
Previous Article in Special Issue
The Social Nature of Perceived Illness Representations of Perinatal Depression in Rural Uganda
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Impact of the Familiar Environment in 11–14-Year-Old Minors’ Mental Health

by
Benito León-del-Barco
1,
Fernando Fajardo-Bullón
2,*,
Santiago Mendo-Lázaro
1,
Irina Rasskin-Gutman
1 and
Damián Iglesias-Gallego
3
1
Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain
2
Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain
3
Department of Didactics of Music, Plastic and Body Expression. Teacher Training College, University of Extremadura, 10071 Cáceres, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(7), 1314; https://doi.org/10.3390/ijerph15071314
Submission received: 30 May 2018 / Revised: 9 June 2018 / Accepted: 20 June 2018 / Published: 23 June 2018
(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)

Abstract

:
The analysis of the mental health in children under 14 years has become a research topic of global interest where the family can be a key factor for protection or risk against mental health problems. With this work, we intend to determine, employing binary logistic regression analysis, whether parental acceptance-rejection perceived by boys and girls can predict their mental health. Seven hundred sixty-two students participated, the average age was 12.23 years; 53.8% (n = 410) girls and 46.2% (n = 352) boys. We have used the Strengths and Difficulties Questionnaire (SDQ), self-reported version and the Affection Scale children version (EA-H) for parental acceptance-rejection to assess mental health. The odds ratio (OR) of the logistic models reports that there is a greater probability of having mental health problems in boys and girls when they perceive that they are highly criticized and rejected by their parents. With our work, we highlight the importance of the environment and family affection on mental health. The perception of the children about the rejection, aversion, and criticism of their parents constitutes a risk factor in the manifestation of mental health problems.

1. Introduction

1.1. Mental Health and Family Variables

Mental health problems in children and adolescents raise a great social concern because they are associated with disability, suffering, functional deterioration, and carry a great economic cost for public health throughout the world [1,2]. Overall, it is estimated that between 10% and 20% of children suffer from mental health problems [3]. Other studies, such as the Spanish National Health Survey 2006, carried out with the Strengths and Difficulties Questionnaire (SDQ) [4], indicated that between 19.2% and 26.6% of the Spanish children and adolescents aged 4 to 15 years were at risk of suffering from mental health problems [5]. Furthermore, the review carried out by Polanczyk, which included 41 studies conducted in 27 countries from all regions of the world, found that the prevalence of mental disorders in children and adolescents was 13.4% [6]. The analysis of the mental health of children under 14 years old has become a topic of research of global interest where the family can be a key factor for their protection or risk at the time they face mental health problems [7]. In this sense, there is a significant association between suicide attempts and relationship problems among the adolescents [8], and family could be a main source of these relationship problems. Parents are the main source of socialization and development of every person from an early age. In the general population the influence of the family context on the psychosocial development of children is indisputable; parents are one of the most powerful influences in the lives of their children [9].
The main studies that have used the Strengths and Difficulties Questionnaire (SDQ) to relate family variables, emotional disorders, and behavioral problems as indicators of mental health, have analyzed different factors such as education level, social class, family type, employment status, and parental health. Regarding the education level, the results show that there is a strong association between the education level of parents and the children’s mental health informed by parents [10,11,12,13,14]. In this regard, the children of mothers with a primary education level had worse mental health than the children of mothers with university education level [15]. According to this, when a mother obtains a high level of education, it reduces the probability of children having mental health problems [16].
For the studies that have related occupational class of parents with mental health, three social classes are frequently used: high, medium, and low [5]. The results show that those jobs of the primary wage earner with lower categories are those most related to the presence of mental health problems in children [17], where parental rejection was more prevalent among parents with little education and a low family socio-economic level [18]. On the contrary, it is the families with jobs corresponding to the middle and the most privileged classes that become a higher protective factor against the presence of mental health problems in the minors than those linked to disadvantaged classes [12,13,15,17]. In general, those children with families with poorer socioeconomic status have worse physical and mental health than those with a higher socioeconomic level [14,19,20,21]. As socioeconomic status decreases, there is an increment of family stress and the use of corporal punishment; this, in turn, can predict behavior problems in minors [22,23].
Other variables that have been shown to be significant for the minor's mental health have been the type of single-parent family [12,13,15], as well as the fact that some family members, or all of them, are unemployed [16]. Likewise, the influence of poor mental health of the parents and the health of the mother has been analyzed and there is evidence to show that the mental health of the parents, especially the health of the mother, are related to the mental well-being of their children [24,25].

1.2. The Present Study

Some studies have analyzed family relationships from the point of view of family violence, either between parents [26,27] or from parents to children [28]. In this sense, the “Interpersonal Acceptance-Rejection theory” (IPARTheory) [29] analyzes the influence of parents’ affections on their children and how these perceptions or experiences can affect the cognitive and socio-emotional adjustment of children [9]. According to Rohner [29], the parental acceptance-rejection implies a continuum. At one end would be parents who show their children love and affection both verbally and physically, at the other end we would find parents who feel aversion towards their children, criticize them, and reject them [30]. This theory has been internationally accepted with research in more than 22 different countries [31]. Some remarkable results show how affection and communication prevent misbehavior in children and stimulate positive development [32]. In this sense, the positive affectivity of parents on children constitutes a preventative requirement for mental health [33], with rejection being a risk factor in the appearance of psychopathologies [34], violent behavior, and poor emotional decoding abilities [35].
On the other hand, investigations such as Muris, Meesters, Morren, and Moorman [36], Repetti, Taylor, and Seeman [37], and Steinberg [38], confirm that inadequate levels of affection and support, as well as the predominance of aggression and rejection towards the children, are related to the manifestation of behavioral problems of aggressiveness, hostility, and delinquency. We know that a lack of affection from the mother, together with the rejection of the father, can be related to a greater probability of being an aggressor in situations of bullying [39], but we do not know the direct relationship with the minor's mental health. Some studies indicate that rejection by both parents is a mediating factor between parental depression and minor’s mental health problems, influencing psychosocial difficulties [40]. In turn, children’s perception of a positive affection from their parents seems to be a preventive factor for good mental health [41].
It is known that in the first years of adolescence development, minors are more exposed to behavioral or relational problems, learning to manage and regulate their behavior as they move towards a middle or late stage of adolescence [42]. Although as the children grow they perceive a decrease in support and involvement in both parents, as well as a weaker control and supervision are noticed [43], various studies from the perspective of parental acceptance-rejection have already shown how age does not influence the psychological adjustment produced in situations of rejection by both parents [44]. Despite the fact that multiple factors (such as individual, developmental, family, social, and contextual factors) may affect the parental function, the focus in this research has been on the type of family relationship.
The conceptions of parents about education, interpersonal relationships, and parenting styles are determining factors in the development of children. More studies are needed to analyze the child-to-parent relationships of rejection and affection, and its relation to the minor’s mental health. With this work, we aimed to determine, by means of a binary logistic regression analysis, if the acceptance-rejection perceived by the children related to their parents can predict their mental health. Why are we interested in the perception of children about the acceptance-rejection of their parents? First, there is a low coincidence between the opinions of parents and children about parental practices. Parents usually have their own perception of their parental practices, sometimes biased by a social desirability. On the other hand, the perception of adolescent children is less biased and is more objective, thus it can be an important predictor of their responses, indeed, more so than the perceptions of their parents [45,46]. For this reason, we also use the Strengths and Difficulties Questionnaire (SDQ) in the self-reported version to evaluate mental health.

2. Materials and Methods

2.1. Sample

The sample was made up of 762 students. The mean age was 12.23 years (SD = 1.122, range 11–14); 53.8% (n = 410) girls and 46.2% (n = 352) boys. The number of participants was determined from the number of students enrolled in Primary Education and Compulsory Secondary Education (ESO) in public and private schools in the Community of Extremadura (Spain) during the 2016-2017 academic year, considering a sampling error of 3% and a confidence level of 95.5%. The selection of the sample was made through a multistage sampling by conglomerates and random selection of the groups in the centers that had several classrooms per grade, 5th and 6th of Primary Education and 1st and 2nd of Compulsory Secondary Education. Cluster sampling was carried out by randomly selecting four schools. Regarding the distribution by course of our participants, 22% were in the 5th grade of Primary Education (10–11-year-olds), 23.1% in the 6th grade of Primary Education (11–12-year-olds), 26.3% were in the 1st grade of Compulsory Secondary Education (12–13-year-olds), and 28.6% were in the 2nd grade of Compulsory Secondary Education (13–14-year-olds).
This age interval presents typical aspects in terms of psychological development that must be taken into account. Many studies confirm that the endocrine changes that begin in late-childhood, and that continuous through puberty, increases the risk of health problems, especially those concerned with emotional and behavior control [47,48]. These changes, along with their interaction with the social environment in which the child develops, are key for understanding the adolescent adjustment in terms of mental health. Parenting behavior also changes during this stage of lifespan [49,50] along with the increment of family conflicts due to a renegotiation of positions within the family [49,51].

2.2. Data Collection Instruments

Strengths and Difficulties Questionnaire, SDQ [4]. This questionnaire has proved to be an excellent screening tool compared to other more classic ones such as the Child Behavior Checklist [52,53]. The SDQ has been validated internationally [54] and has been used in many international studies for the measurement of mental health. There are three versions of the SDQ: one for parents, one for teachers, and another for self-report that is advisable after the age of 11. The content and structure of the SDQ has been developed using as a reference the childhood mental health disorders described by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. [55,56]. The SDQ-self-reported version is a brief instrument, excellent for the screening of mental health disorders in children, taking into account the last 6 months, with an internal consistency highlighted in all its scales, both internationally [57,58] and in its Spanish version [59,60]. It consists of 25 items divided into five dimensions or subscales (1. Emotional Symptoms, 2. Behavioral Problems, 3. Peer Problems, 4. Hyperactivity, and 5. Prosocial Behavior). Each of the subscales is valued through five items. The answer format is of the Likert type with 3 degrees (0 = No, nothing, 1 = Sometimes, and 2 = Yes, always). The total score in difficulties is obtained by adding the four scales without considering the prosocial scale.
For community samples, it is recommended to group the items of the Behavioral Problems subscale and the items of the Hyperactivity subscale in a new scale called Externalizing Problems [55]. In the same way, the items of the subscale Emotional Symptoms are added with the items of the subscale Peer Problems to create the Internalizing Problems scale [54]. Both the total score of the SDQ and the scores of the different subscales and scales are classified into three categories: Normal, Borderline, and Abnormal. In the original scale [4], the limit of the Abnormal category corresponds to the score that delimits the top 10% of cases (Percentile ≥ 90), while the Borderline category corresponds to 10% of cases between the 80th percentile and 90th percentile. The overall reliability of the scale presents a Cronbach's alpha (α) of 0.66 and Composite Reliability (CR) of 0.80, the scale of Internalizing Problems an α of 0.57 and CR of 0.72, and the scale of Externalizing Problems a α of 0.45 and CR of 0.76.
Affection Scale children version, EA-H [61]. It consists of two factors, each of them with 10 items that are presented in a Likert scale format, with five degrees of frequency that represent a continuum from Never to Always. The first factor called Affection-Communication evaluates the perception that children have of the affection, interest, and communication that their parents (Father-Mother) express towards them: “It comforts me when I am sad”, “It accepts me as I am”, “He is affectionate to me”. The first factor has an α of 0.85 and CR FC of 0.86 for the parent mode and for the mother modality an α = 0.82 and CR = 0.84. The second factor called Critical-Rejection evaluates the criticism, the rejection, and the lack of parental trust (Father-Mother) towards their children: “What I do seems wrong to him”, “He is upset when I am at home”, “He would like it to be different”. It has α = 0.82 and CR = 0.83 for the parent mode and α = 0.77 and CR = 0.79 for the mother modality.

2.3. Procedure

The procedure followed for collecting data was the administration of the questionnaires by classroom group. In the first place, we contacted the educational centers to explain the objectives of the study and request authorization for the completion of the questionnaires. We followed the ethical guidelines of the American Psychological Association [62] regarding the informed consent of the parents, due to participants’ being underage. Likewise, anonymity in the answers, the confidentiality of the obtained data, and its exclusive use for research purposes was assured. The administration of the questionnaires was done during school hours, it took around 40 min in an adequate climate and without distractions. This study was approved by the Bioethics and Biosafety Committee of the University of Extremadura (NO. 0063/2018).

2.4. Data Analysis

The statistical analysis carried out included analysis of reliability of the instruments used, measure of association odds ratio (OR), and binary logistic regression using the SPSS “enter method”. Prior to these analyses, another analysis of missing data was performed with the variables included in the models analyzed. As we have mentioned, the analyses were performed with the statistical package SPSS version 21.0 (IBM Corp., Armonk, NY, USA) for personal computer (PC).

3. Results

Our main objective is to determine, through a binary logistic regression analysis, whether the acceptance-rejection perceived by boys and girls of their parents can predict their mental health. However, by initially using the OR ratio statistics tools, we want to analyze the association between participants’ gender and mental health. In order to achieve this, the total scores of the SDQ (Mental Health Problems), the Internalizing Problems scale and the Externalizing Problems scale were used as dependent variables. These variables were transformed into dichotomous variables from the 80th percentile (p ≥ 80 = “Suffering Problems”; p < 80 = “No suffering Problems”). In the category of “Having Mental Health Problems, Having Internalizing Problems and Having Externalizing Problems” were grouped the subjects of the Abnormal and Borderline categories of the original scale [4].
As we can see in Table 1, there is a significant association between the variable “gender” and the SDQ Total Score and the Externalizing Problems. Regarding the association with the SDQ Total Score, the following data were obtained: OR = 2.199, the limits of the ratios, 95% confidence, did not contain the unit, and the χ2 = 18.421 confirmed the significance of these results (p < 0.001). Thereby, being a boy is a risk as far as the presence of mental health problems is concerned. The probability of having mental health problems is 2.19 times higher in boys than in girls. Also, regarding the association with the Externalizing Problems variable, an OR = 2.484 was obtained and both the limits of the ratios (1.746–3.535) and the χ2 = 26.456 confirmed the significance of the results (p < 0.001). The probability of having Externalizing Problems is almost 2.5 times higher in boys than in girls.
Regarding our main objective, in order to confirm whether children’s perception of affection, communication, criticism, and rejection by their parents (father or mother) can significantly predict the mental health of their children, a binary logistic regression analysis was carried out. The dichotomous variables of the total score of the SDQ (Mental Health Problems), of the Internalizing Problems scale, and of the Externalizing Problems scale were used as dependent variables and as predictor variables, the four factors of the EA-H (Affection and Father communication, Affection and Mother communication, Criticism and rejection Father, Criticism and rejection Mother) were grouped as dichotomous variables (Normal = 0, High = 1) from the 80th percentile (p < 80 = 0, p ≥ 80 = 1).
Three predictive models are created by gender (girls and boys) (Table 2). The predictive model for the total score of the SDQ (Mental Health Problems) allows a correct estimation of 85.8% of the cases (χ2 = 27.706(4), p < 0.001) in girls (Cox & Snell’s R2 = 0.066; Nagelkerke’s R2 = 0.118) and of 76.7% of the cases (χ2 = 25.7634), p < 0.001) in Boys (Cox & Snell’s R2 = 0.071; Nagelkerke’s R2 = 0.103). The model for Internalizing Problems allows a correct estimation of 81.4% of the cases (χ2 = 33.145(4), p < 0.001) in girls (Cox & Snell’s R2 = 0.078, Nagelkerke’s R2 = 0.125) and of 78.4% of cases (χ2 = 18.908), p = 0.001) in boys (Cox & Snell’s R2 = 0.052, Nagelkerke’s R2 = 0.080). The model for Externalizing Problems is not significant in the case of girls (χ2 = 4.475(4), p = 0.3461) and allows a correct estimation of 72.7% of the cases (χ2 = 27.611(4), p < 0.001) in the case of the boys (Cox & Snell’s R2 = 0.075; Nagelkerke’s R2 = 0.106).
The OR of the logistic models report that: (1) the probability of having mental health problems is 5.7 times higher in girls who perceive that they are highly criticized and rejected by their father and 3 times higher in boys who perceive that they are highly criticized and rejected by their mothers; (2) the probability of having internal problems is 6 times higher in girls who perceive that they are highly criticized by their fathers; (3) boys perceive that they are highly criticized or rejected by their mothers are 2.2 and 2.5 times more likely to have internal and external problems, respectively.

4. Discussion

The results confirm that being a boy is a risk factor for the presence of mental health problems. The probability of having mental health problems is 2.19 times higher in boys than in girls. Also, the probability of having Externalizing Problems (Behavioral and Hyperactivity) is almost 2.5 times higher in boys than in girls. These results are consistent with a large majority of research that, independently of the version of SDQ used (Parents, Teachers, or Self-Reported), confirm that males obtain a higher score in external symptoms, such as behavior problems and hyperactivity [63,64,65,66]. A wider range of studies that support these same results can be observed in the work carried out by Ortuño-Sierra that includes an international review [42] and in other academic literature about meta-analysis of transcultural studies [67].
Regarding our main objective, the ORs of the logistic models report in a general way that there is a greater probability of having mental health problems and manifest internal and external symptoms in boys who perceive that they are highly criticized and rejected by their mothers. Girls who perceive that they are highly criticized by their fathers are more likely to have mental health problems and internal symptoms. The rejection, aversion, and criticism that children perceived by their parents constitutes a risk factor in the manifestation of mental health problems. These results coincide with other recent studies with a Spanish population of similar characteristics [44,68,69] and with Repetti's studies [37] that relate parental styles characterized by a predominance of aggression and rejection towards children with the manifestation of mental health problems and behavioral problems of aggression, hostility, and delinquency. Numerous studies highlight how a negative emotional attitude characterized by lack of affection and communication increases the risk of manifesting behavioral and health problems [46,70] regardless of whether the child or the parents report [32].
Based on the results obtained in our research, we asked ourselves some questions. One of them was about why the rejection of fathers is a risk factor for girls and the maternal rejection a risk factor for boys? Regarding this issue, various investigations show that the influence exerted by fathers and mothers in the upbringing of their children is different.
In general, social learning theories expected that the behavior of the father would be more determinant for the boys, since it is a learning role model as could be the mother for the daughters [71]. However, the results are uneven. In general, girls feel the influence of both parents, while boys perceive a greater influence of mothers. Likewise, parents are more likely to overprotect their daughters than their sons, and the parenting factors associated to the father appear as predictors of negative behavior in daughters [46,72,73]. In this sense, some studies indicate that difficulties with the father at 13–14 years produce a higher cost in the mental health of girls than they produce in boys [74], or that the father’s preference to spend more time with the son than with the daughter may influence the lower presence of negative symptoms in the son [75], but not in the daughters [71]. Taking into account the differences related to gender, the situations of maternal rejection in minors seems to have a greater emotional impact in sons than in daughters, according to stated memory when they become adults [76]. Linking with the type of symptomatology analyzed above, other studies support our results with a differentiation depending on whose rejection, paternal or maternal, is concerned. Specifically, the contribution of paternal rejection tends to develop emotional disorders like negative self-esteem, negative self-adequacy, emotional unresponsiveness, and emotional instability. All of which are related to internalizing disorders that appear more often in girls. In a different direction, the contribution of maternal rejection is higher regarding the externalizing dimensions of hostility and dependence, more characteristic in boys [44]. In this sense, it is interesting to observe that when there is a greater participation and involvement of the father, the externalizing and internalizing symptomatology of the minors is diminished in both sexes [31,71,77]. Due to this, it would be interesting to incorporate the measurement of this variable in future investigations.
Another question we asked was about why acceptance, love, and communication of parents are not factors of protection against mental health problems? In our case, it seems that there are no differences in terms of affection and communication between parents and their children, boys and girls. This may be due to the greater affective autonomy present in the developmental stage in which they are beginning as adolescents [44]. However, the rejection of the father worsens mental health problems in the daughters, and the rejection of the mother worsens mental health problems in the sons. Coinciding with other studies [34], the rejection factor is a highly determinant factor, in comparison with acceptance, for the appearance of psychological and behavioral problems in minors [76], demonstrating its influence at a transcultural level [78]. This invalidating environment could lead to borderline personality disorders [79] and various, internalized and/or externalized alterations in the children, such as depression, suicidal behavior, anxiety, aggressiveness, and hostility [31,76]. However, other studies have suggested that parental acceptance is a more relevant factor for boys than for girls, and even that father´s rejection is the most influential in boys and girls [31]. Finally, we can observe how our results complement the international studies on parental acceptance-rejection [80], providing a greater influence of the rejection of fathers and mothers in children of the opposite sex, between 11 and 14 years old.

Study Limitations and Future Directions.

The study has several limitations, such as the use of self-reports by participants both for the evaluation of mental health problems and parental acceptance-rejection. It is important to point out that, although the content and structure of the SDQ has been developed using as a reference the childhood mental health disorders described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [55,56], and it has proven to be a good predictor of disorders reported in the International Classification of Diseases (ICD-10) [81], the SDQ is a mental health screening tool, not a determinant by itself for clinical diagnosis [7]. The questionnaire employed in the present study measures child's self-perception of affection, communication, criticism, and rejection of their parents. The use of self-reported questionnaires, such as the SDQ, for measuring health conditions in national surveys is widely used [82]; however, the findings may be biased if there is a differential recall based on mental health problems. Despite the fact that the SDQ refers to the last 6 months, and the EA-H to the moment when the child is completing the questionnaire, it is important to take into account that there may be a bias on recall known as “effort after meaning” [83,84], through which the child can justify his or her symptoms based on past experiences [85]. Thus, we consider that it would be important to have other informants in addition to those directly involved. In this sense, teachers have a privileged situation to analyze minor’s mental health problems since they can observe and evaluate them in the classroom in daily situations, and they can establish comparisons with other children of the same developmental level. Likewise, within a bidirectional model of parent-child relationships, it would be convenient to evaluate mental health and acceptance-rejection from the point of view of parents. On the other hand, the results should be analyzed with caution when extrapolating them to other countries, especially non-Western ones, because of the cultural influence [78]. Finally, this study did not assess other potential confounding factors which contribute to depression and family problems in children and adolescents including obesity [86], chronic diseases such as asthma [87] and dermatitis [88] leading to negative impact on family [89], online isolation due to excessive internet use [90], and father involvement [77].

5. Conclusions

The conclusions of this study strengthen the evidence of how the probability of having mental health problems, measured by the SDQ-self-reported version in Spanish minors, is more than double in boys than that in girls, this difference can be even greater when it comes to externalizing symptoms (Behavior Problems and Hyperactivity). However, no differences are obtained in the internalizing symptoms according to the gender of the Spanish minors.
On the other hand, the probability of suffering mental health problems increases in girls 5.7 times when they perceive criticism and rejection of the father. In the same line, the probability of suffering mental health problems in boys triples when they perceive criticism and rejection of the mother. No significant differences appear when they suffer this rejection by the parental figure of their same sex.
More specifically, it is observed that girls who perceive criticism and rejection of their father, are 6 times more likely to suffer mental health problems of the internalizing type. In the case of boys who perceive criticism and rejection by the mother, they are twice as likely to have mental health problems in both symptomatology, internalizing, and externalizing.
Finally, we are aware of how mental health problems in children and adolescents cause great social concern and entail a great economic cost for public health throughout the world. With our work, we have highlighted the importance of the environment and family affection on mental health. The rejection, aversion, and criticism perceived by the children from their parents constitutes a risk factor in the manifestation of mental health problems. People who have been emotionally rejected tend in turn to reject any affective approach of other people, and favor a climate of lack of affection and rejection towards others [24]. Understanding the factors associated with mental health problems in children and adolescents can facilitate early identification of children at risk and the implementation of prevention programs [14]. Likewise, it would be advisable to design intervention and training programs with families that can improve relations between parents and children [46]. We also believe in parent training oriented to discover if the origins of their children’s problems can be found in their own behavior. This training would increase the awareness of parents and the use of their skills and competences. Parent-training programs are a way to promote their development, they improve family relationships and reinforce the sense of satisfaction and competence of parents regarding their tasks and parental responsibilities. Finally, new research seems to be necessary that can provide possible solutions, both from the point of view of intervention with the parents—to prevent their children from having a tendency to social rejection and acceptance difficulties—as well as from prevention through direct work with the minors [76].

Author Contributions

B.L.-d.B. and F.F.-B. designed the study. B.L.-d.B. had full access to all the data in the study and performed all statistical analyses. S.M-L. took part in the conduction of the surveys and contributed to the data analysis. F.F.-B., D.I-G., and I.R.-G. contributed to the interpretation of the data and manuscript preparation. All authors have read and approved the final manuscript.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Belfer, M.L. Child and adolescent mental disorders: The magnitude of the problem across the globe. J. Child Psychol. Psychiatry Allied Discip. 2008, 49, 226–236. [Google Scholar] [CrossRef] [PubMed]
  2. Beecham, J. Annual research review: Child and adolescent mental health interventions: A review of progress in economic studies across different disorders. J. Child Psychol. Psychiatry Allied Discip. 2014, 55, 714–732. [Google Scholar] [CrossRef] [PubMed]
  3. Husky, M.M.; Boyd, A.; Bitfoi, A.; Carta, M.G.; Chan-Chee, C.; Goelitz, D.; Koç, C.; Lesinskiene, S.; Mihova, Z.; Otten, R.; et al. Self-reported mental health in children ages 6–12 years across eight European countries. Eur. Child Adolesc. Psychiatry 2017. [Google Scholar] [CrossRef] [PubMed]
  4. Goodman, R. The strengths and difficulties questionnaire: A research note. J. Child Psychol. Psychiatry Allied Discip. 1997, 38, 581–586. [Google Scholar] [CrossRef]
  5. Fajardo-Bullon, F.; Leon, B.; Felipe-Castaño, E.; Santos, E.J. Mental health in the age group 4–15 years based on the results of the national survey of health 2006. Rev. Esp. Salud Publica 2012, 86, 445–451. [Google Scholar] [CrossRef] [PubMed]
  6. Polanczyk, G.V.; Salum, G.A.; Sugaya, L.S.; Caye, A.; Rohde, L.A. Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J. Child Psychol. Psychiatry 2015, 56, 345–365. [Google Scholar] [CrossRef] [PubMed]
  7. Fajardo-Bullón, F.; León del Barco, B.; Felipe-Castaño, E.; Polo del Río, M.I.; Santos, E. Mental health in Spanish minors. Socioeducational variables. Salud Ment. 2015, 38, 329–335. [Google Scholar] [CrossRef]
  8. Choo, C.; Chew, P.; Ho, R. Suicide Precipitants Differ Across the Lifespan but are not Significant in Predicting Medically Severe Attempts. Int. J. Environ. Res. Public Health 2018, 15, 691. [Google Scholar] [CrossRef] [PubMed]
  9. Fernández-García, C.-M.; Rodríguez-Menéndez, C.; Peña-Calvo, J.-V. Parental control in interpersonal acceptance-rejection theory: A study with a Spanish sample using Parents’ Version of Parental Acceptation-Rejection/Control Questionnaire. An. Psicol. 2017, 33, 652. [Google Scholar] [CrossRef]
  10. Davis, E.; Sawyer, M.G.; Lo, S.K.; Priest, N.; Wake, M. Socioeconomic Risk Factors for Mental Health Problems in 4–5-Year-Old Children: Australian Population Study. Acad. Pediatr. 2010, 10, 41–47. [Google Scholar] [CrossRef] [PubMed]
  11. Perna, L.; Bolte, G.; Mayrhofer, H.; Spies, G.; Mielck, A. The impact of the social environment on children’s mental health in a prosperous city: An analysis with data from the city of Munich. BMC Public Health 2010, 10, 199. [Google Scholar] [CrossRef] [PubMed]
  12. Rajmil, L.; López-Aguilà, S.; Mompart Penina, A.; Medina Bustos, A.; Rodríguez Sanz, M.; Brugulat Guiteras, P. Socio-economic inequalities in children’s mental health in Catalonia. An. Pediatría 2010, 73, 233–240. [Google Scholar] [CrossRef] [PubMed]
  13. Sonego, M.; Llácer, A.; Galán, I.; Simón, F. The influence of parental education on child mental health in Spain. Qual. Life Res. 2013, 22, 203–211. [Google Scholar] [CrossRef] [PubMed]
  14. Wlodarczyk, O.; Pawils, S.; Metzner, F.; Kriston, L.; Klasen, F.; Ravens-Sieberer, U. Risk and protective factors for mental health problems in preschool-aged children: Cross-sectional results of the BELLA preschool study. Child Adolesc. Psychiatry Ment. Health 2017, 11, 12. [Google Scholar] [CrossRef] [PubMed]
  15. Lapresa, L.-B.; Arizaleta, L.-H.; Rajmil, L. Social Inequalities in Mental Health and Health-Related Quality of Life in Children in Spain. Pediatrics 2012, 130, e528–e535. [Google Scholar] [CrossRef] [PubMed]
  16. Arroyo-Borrell, E.; Renart, G.; Saurina, C.; Saez, M. Influence maternal background has on children’s mental health. Int. J. Equity Health 2017, 16, 63. [Google Scholar] [CrossRef] [PubMed]
  17. Fajardo-Bullón, F.; Rasskin-Gutman, I.; Felipe-Castaño, E.; Ribeiro-dos-Santos, E.J.; León-del Barco, B. Analysis of Predictive Factors on Minors’ Mental Health According to the Spanish National Health Survey. Brain Sci. 2017, 7, 135. [Google Scholar] [CrossRef] [PubMed]
  18. Dwairy, M.; Achoui, M.; Filus, A.; Rezvan nia, P.; Casullo, M.M.; Vohra, N. Parenting, Mental Health and Culture: A Fifth Cross-Cultural Research on Parenting and Psychological Adjustment of Children. J. Child Fam. Stud. 2010, 19, 36–41. [Google Scholar] [CrossRef]
  19. Klanšček, H.; Žiberna, J.; Korošec, A.; Zurc, J.; Albreht, T. Mental health inequalities in Slovenian 15-year-old adolescents explained by personal social position and family socioeconomic status. Int. J. Equity Health 2014, 13, 26. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  20. Potijk, M.R.; de Winter, A.F.; Bos, A.F.; Kerstjens, J.M.; Reijneveld, S.A. Behavioural and emotional problems in moderately preterm children with low socioeconomic status: A population-based study. Eur. Child Adolesc. Psychiatry 2015, 24, 787–795. [Google Scholar] [CrossRef] [PubMed]
  21. Starfield, B.; Riley, A.W.; Witt, W.P.; Robertson, J. Social class gradients in health during adolescence. J. Epidemiol. Community Health 2002, 56, 354–361. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  22. Lila, M.; Gracia, E. Determinants of parental acceptance-rejection. Psicothema 2005, 17, 107–111. [Google Scholar]
  23. Pinderhughes, E.E.; Dodge, K.A.; Bates, J.E.; Pettit, G.S.; Zelli, A. Discipline responses: Influences of parents’ socioeconomic status, ethnicity, beliefs about parenting, stress, and cognitive-emotional processes. J. Fam. Psychol. 2000, 14, 380–400. [Google Scholar] [CrossRef] [PubMed]
  24. Plass-Christl, A.; Haller, A.-C.; Otto, C.; Barkmann, C.; Wiegand-Grefe, S.; Holling, H.; Schulte-Markwort, M.; Ravens-Sieberer, U.; Klasen, F. Parents with mental health problems and their children in a German population based sample: Results of the BELLA study. PLoS ONE 2017, 12, e0180410. [Google Scholar] [CrossRef] [PubMed]
  25. Grazuleviciene, R.; Andrusaityte, S.; Petraviciene, I.; Balseviciene, B. Impact of psychosocial environment on young children’s emotional and behavioral difficulties. Int. J. Environ. Res. Public Health 2017, 14, 1278. [Google Scholar] [CrossRef] [PubMed]
  26. Fong, V.C.; Hawes, D.; Allen, J.L. A Systematic Review of Risk and Protective Factors for Externalizing Problems in Children Exposed to Intimate Partner Violence. Trauma Violence Abus. 2017. [Google Scholar] [CrossRef] [PubMed]
  27. Khaleque, A. Perceived Parental Hostility and Aggression, and Children’s Psychological Maladjustment, and Negative Personality Dispositions: A Meta-Analysis. J. Child Fam. Stud. 2017, 26, 977–988. [Google Scholar] [CrossRef]
  28. Bunston, W.; Franich-Ray, C.; Tatlow, S. A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults. Brain Sci. 2017, 7, 133. [Google Scholar] [CrossRef] [PubMed]
  29. Rohner, R.P. They Love Me, They Love Me Not: A Worldwide Study of the Effects of Parental Acceptance and Rejection; HRAF Press: New Haven, CT, USA, 1975. [Google Scholar]
  30. Rohner, R.P.; Carrasco, M.Á. Interpersonal Acceptance-Rejection Theory (IPARTheory): Theoretical Bases, Method and Empirical Evidence. Acción Psicol. 2014, 11, 9–26. [Google Scholar] [CrossRef]
  31. Khaleque, A.; Rohner, R.P. Pancultural Associations Between Perceived Parental Acceptance and Psychological Adjustment of Children and Adults: A Meta-Analytic Review of Worldwide Research. J. Cross-Cult. Psychol. 2012, 43, 784–800. [Google Scholar] [CrossRef]
  32. Gracia, E.; Lila, M.; Musitu, G. Parental rejection and psychological and social adjustment of children. Salud Ment. 2005, 28, 73–81. [Google Scholar]
  33. Funes, J. The New Juvenile and Juvenile Delinquency; Ediciones Paidós: Barcelona, Spain, 1984; ISBN 9788475092775. [Google Scholar]
  34. Rohner, R.P.; Britner, P.A. Worldwide Mental Health Correlates of Parental Acceptance-Rejection: Review of Cross-Cultural and Intracultural Evidence. Cross-Cult. Res. 2002, 36, 16–47. [Google Scholar] [CrossRef]
  35. Romero-Martínez, Á.; Lila, M.; Catalá-Miñana, A.; Williams, R.; Moya-Albiol, L. The Contribution of Childhood Parental Rejection and Early Androgen Exposure to Impairments in Socio-Cognitive Skills in Intimate Partner Violence Perpetrators with High Alcohol Consumption. Int. J. Environ. Res. Public Health 2013, 10, 3753–3770. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  36. Muris, P.; Meesters, C.; Morren, M.; Moorman, L. Anger and hostility in adolescents: Relationships with self-reported attachment style and perceived parental rearing styles. J. Psychosom. Res. 2004, 57, 257–264. [Google Scholar] [CrossRef]
  37. Repetti, R.L.; Taylor, S.E.; Seeman, T.E. Risky families: Family social environments and the mental and physical health of offspring. Psychol. Bull. 2002, 128, 330–366. [Google Scholar] [CrossRef] [PubMed]
  38. Steinberg, L. We Know Some Things : Parent—Adolescent Relationships in Retrospect and Prospect. J. Res. Adolesc. 2001, 11. [Google Scholar] [CrossRef]
  39. León, B.; Felipe-Castaño, E.; Polo, M.I.; Fajardo-Bullón, F. Parental acceptance-rejection and profiles of victimization and aggression in bullying situations. An. Psicol. 2015, 31, 600–606. [Google Scholar] [CrossRef]
  40. Kim, E. Korean American Parental Depressive Symptoms and Children’s Mental Health: The Mediating Role of Parental Acceptance–Rejection. J. Pediatr. Nurs. 2013, 28, 37–47. [Google Scholar] [CrossRef] [PubMed]
  41. Polo Del Río, M.I.; Fajardo-Bullón, F.; Martín, E.; Gómez-Carroza, T.; León Del Barco, B. Parental acceptance /rejection in a sample of adolescents. Differences according to sex and age. Int. J. Dev. Educ. Psychol. 2012, 1, 329–335. [Google Scholar]
  42. Ortuño-Sierra, J.; Fonseca-Pedrero, E.; Inchausti, F.; Sylvia Sastre i, R. Assesing behavioural and emotional dificulties in the child adolescent population: The strengths and difficulties questionnaire (SDQ). Papeles Psicol. 2016, 37, 14–26. [Google Scholar]
  43. Rodríguez, M.Á.; Del Barrio, M.V.; Carrasco, M.Á. How do children perceive maternal and paternal upbringing? Differences by age and sex. Escr. Psicol. 2009, 2, 10–18. [Google Scholar]
  44. Ramírez-Uclés, I.; González-Calderón, M.J.; del Barrio-Gándara, V.; Carrasco, M.Á. Perceived Parental Acceptance-Rejection and Children’s Psychological Adjustment: The Moderating Effects of Sex and Age. J. Child Fam. Stud. 2018, 27, 1336–1348. [Google Scholar] [CrossRef]
  45. Lamborn, S.D.; Mounts, N.S.; Steinberg, L.; Dornbusch, S.M. Patterns of Competence and Adjustment among Adolescents from Authoritative, Authoritarian, Indulgent, and Neglectful Families. Child Dev. 1991, 62, 1049–1065. [Google Scholar] [CrossRef] [PubMed]
  46. Tur-Porcar, A.; Mestre, V.; Samper, P.; Malonda, E. Upbringing and aggressiveness of minors: Is the influence of the father and the mother different? Psicothema 2012, 24, 284–288. [Google Scholar] [PubMed]
  47. Collishaw, S.; Maughan, B.; Goodman, R.; Pickles, A. Time trends in adolescent mental health. J. Child Psychol. Psychiatry Allied Discip. 2004, 45, 1350–1362. [Google Scholar] [CrossRef]
  48. Mundy, L.K.; Simmons, J.G.; Allen, N.B.; Viner, R.M.; Bayer, J.K.; Olds, T.; Williams, J.; Olsson, C.; Romaniuk, H.; Mensah, F.; et al. Study protocol: The Childhood to Adolescence Transition Study (CATS). BMC Pediatr. 2013, 13, 160. [Google Scholar] [CrossRef] [PubMed]
  49. Lara, B.L.; Victoria, M.; García, H.; Dekovic, M. Adolescent adjustment in at-risk families Adolescent adjustment in at-risk families: The role of psychosocial stress and parental socialization. Salud Ment. 2013, 3636, 49–57. [Google Scholar] [CrossRef]
  50. Paulson SE; Sputa CL Patterns of Parenting During Adolescence: Perceptions of Adolescents and Parents. Adolescence 1996, 31, 369–381.
  51. Laible, D.J.J.; Carlo, G.; Raffaelli, M. The differential relations of parent and peer attachment to adolescent adjustment. J. Youth Adolesc. 2000, 29, 45–59. [Google Scholar] [CrossRef]
  52. Goodman, A.; Goodman, R. Strengths and Difficulties Questionnaire as a Dimensional Measure of Child Mental Health. J. Am. Acad. Child Adolesc. Psychiatry 2009, 48, 400–403. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  53. Goodman, R.; Scott, S. Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is Small Beautiful? J. Abnorm. Child Psychol. 1999, 27, 17–24. [Google Scholar] [CrossRef] [PubMed]
  54. Goodman, A.; Goodman, R. Population mean scores predict child mental disorder rates: Validating SDQ prevalence estimators in Britain. J. Child Psychol. Psychiatry Allied Discip. 2011, 52, 100–108. [Google Scholar] [CrossRef] [PubMed]
  55. Goodman, A.; Lamping, D.L.; Ploubidis, G.B. When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the strengths and difficulties questionnaire (SDQ): Data from british parents, teachers and children. J. Abnorm. Child Psychol. 2010, 38, 1179–1191. [Google Scholar] [CrossRef] [PubMed]
  56. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; American Psychiatric Association: Washington, DC, USA, 2000. [Google Scholar]
  57. Muris, P.; Meesters, C.; van den Berg, F. The Strengths and Difficulties Questionnaire (SDQ). Eur. Child Adolesc. Psychiatry 2003, 12, 1–8. [Google Scholar] [CrossRef] [PubMed]
  58. Gomez, R. Correlated Trait–Correlated Method Minus One Analysis of the Convergent and Discriminant Validities of the Strengths and Difficulties Questionnaire. Assessment 2014, 21, 372–382. [Google Scholar] [CrossRef] [PubMed]
  59. Ortuño-Sierra, J.; Chocarro, E.; Fonseca-Pedrero, E.; i Riba, S.S.; Muñiz, J. The assessment of emotional and Behavioural problems: Internal structure of The Strengths and Difficulties Questionnaire. Int. J. Clin. Health Psychol. 2015, 15, 265–273. [Google Scholar] [CrossRef]
  60. Ortuño-Sierra, J.; Fonseca-Pedrero, E.; Paíno, M.; Aritio-Solana, R. Prevalence of emotional and behavioral symptomatology in Spanish adolescents. Rev. Psiquiatr. Salud Ment. 2014, 7, 121–130. [Google Scholar] [CrossRef] [PubMed]
  61. Bersabé, R.; Fuentes, M.J.; Motrico, E. Psychometric analysis of two scales to evaluate parental educational styles. Psicothema 2001, 13, 678–684. [Google Scholar]
  62. American Psychological Association. Publication manual of the American Psychological Association, 6th ed.; American Psychological Association: Washington, DC, USA, 2010; ISBN 1433805618 (Paperback); 9781433805615 (Paperback); 1433805596 (Hardcover); 9781433805592 (Hardcover); 1433805626 (Spiral); 9781433805622 (Spiral). [Google Scholar]
  63. Kovess-Masfety, V.; Husky, M.M.; Keyes, K.; Hamilton, A.; Pez, O.; Bitfoi, A.; Carta, M.G.; Goelitz, D.; Kuijpers, R.; Otten, R.; et al. Comparing the prevalence of mental health problems in children 6-11 across Europe. Soc. Psychiatry Psychiatr. Epidemiol. 2016, 51, 1093–1103. [Google Scholar] [CrossRef] [PubMed]
  64. Ortuño-Sierra, J.; Aritio-Solana, R.; Fonseca-Pedrero, E. Mental health difficulties in children and adolescents: The study of the SDQ in the Spanish National Health Survey 2011–2012. Psychiatry Res. 2018, 259, 236–242. [Google Scholar] [CrossRef] [PubMed]
  65. Yao, S.; Zhang, C.; Zhu, X.; Jing, X.; McWhinnie, C.M.; Abela, J.R.Z. Measuring adolescent psychopathology: Psychometric properties of the self-report strengths and difficulties questionnaire in a sample of Chinese adolescents. J. Adolesc. Health 2009, 45, 55–62. [Google Scholar] [CrossRef] [PubMed]
  66. Woerner, W.; Becker, A.; Rothenberger, A. Normative data and scale properties of the German parent SDQ. Eur. Child Adolesc. Psychiatry 2004, 13, ii3–ii10. [Google Scholar] [CrossRef] [PubMed]
  67. Khaleque, A. Perceived Parental Neglect, and Children’s Psychological Maladjustment, and Negative Personality Dispositions : A Meta-analysis of Multi-cultural Studies. J. Child Fam. Stud. 2015, 24, 1419–1428. [Google Scholar] [CrossRef]
  68. Carrasco, M.A.; Holgado, F.P.; del Barrio, V. Effects of Parental Interpersonal Power/Prestige and Acceptance on the Psychological Adjustment of Spanish Youth. Cross-Cult. Res. 2014, 48, 305–315. [Google Scholar] [CrossRef]
  69. Carrasco, M.A.; Rohner, R.P. Parental Acceptance and Children’s Psychological Adjustment in the Context of Power and Prestige. J. Child Fam. Stud. 2013, 22, 1130–1137. [Google Scholar] [CrossRef]
  70. Loeber, R.; Stouthamer-Loeber, M. Family Factors as Correlates and Predictors of Juvenile Conduct Problems and Delinquency. Crime Justice 1986, 7, 29–149. [Google Scholar] [CrossRef]
  71. Keizer, R.; Lucassen, N.; Jaddoe, V.; Tiemeier, H. A prospective study on father involvement and toddlers’ behavioral and emotional problems: Are sons and daughters differentially affected? Fathering 2014, 12, 38–51. [Google Scholar] [CrossRef]
  72. Laible, D.J.; Carlo, G. The Differential Relations of Maternal and Paternal Support and Control to Adolescent Social Competence, Self-Worth, and Sympathy. J. Adolesc. Res. 2004, 19, 759–782. [Google Scholar] [CrossRef] [Green Version]
  73. Tavassolie, T.; Dudding, S.; Madigan, A.L.; Thorvardarson, E.; Winsler, A. Differences in Perceived Parenting Style Between Mothers and Fathers: Implications for Child Outcomes and Marital Conflict. J. Child Fam. Stud. 2016, 25, 2055–2068. [Google Scholar] [CrossRef]
  74. Facio, A.; Resett, S.; Mistrorigo, C.; Micocci, F. Argentine Teenagers: How They Think and Feel; Aires, B., Ed.; Quora: Mountain View, CA, USA, 2006; ISBN 9789508922694. [Google Scholar]
  75. Bronte-Tinkew, J.; Moore, K.A.; Carrano, J. The father-child relationship, parenting stvles. and adolescent risk behaviors in intact families. J. Fam. Issues 2006, 27, 850–881. [Google Scholar] [CrossRef]
  76. Ali, S.; Khaleque, A.; Rohner, R.P. Pancultural Gender Differences in the Relation Between Perceived Parental Acceptance and Psychological Adjustment of Children and Adult Offspring: A Meta-Analytic Review of Worldwide Research. J. Cross-Cult. Psychol. 2015, 46, 1059–1080. [Google Scholar] [CrossRef]
  77. Rodríguez Ruíz, M.M.; Carrasco, M.; Holgado-Tello, F.P. Father involvement and children’s psychological adjustment: Maternal and paternal acceptance as mediators. J. Fam. Stud. 2016, 1–19. [Google Scholar] [CrossRef]
  78. Dwairy, M. Parental Acceptance–Rejection: A Fourth Cross-Cultural Research on Parenting and Psychological Adjustment of Children. J. Child Fam. Stud. 2010, 19, 30–35. [Google Scholar] [CrossRef]
  79. Puri, B.K.; Hall, A.; Ho, R. Revision Notes in Psychiatry, 3rd ed.; CRC Press: Boca Raton, FL, USA, 2013. [Google Scholar]
  80. Khaleque, A.; Ali, S. A Systematic Review of Meta-Analyses of Research on Interpersonal Acceptance-rejection Theory: Constructs and Measures. J. Fam. Theory Rev. 2017, 9, 441–458. [Google Scholar] [CrossRef]
  81. Kuhn, C.; Aebi, M.; Jakobsen, H.; Banaschewski, T.; Poustka, L.; Grimmer, Y.; Goodman, R.; Steinhausen, H.C. Effective Mental Health Screening in Adolescents: Should We Collect Data from Youth, Parents or Both? Child Psychiatry Hum. Dev. 2017, 48, 385–392. [Google Scholar] [CrossRef] [PubMed]
  82. World Health Organization. Health Interview Surveys: Towards International Harmonization of Methods and Instruments; WHO Office for Europe: Copenhagen, Denmark, 1996. [Google Scholar]
  83. Bartlett, F.C. Remembering : A Study in Experimental and Social Psychology; Cambridge University Press: Cambridge, UK, 1932; ISBN 0521483565. [Google Scholar]
  84. Zaromb, F.M.; Roediger, H.L. The effects of “effort after meaning” on recall: Differences in within- and between-subjects designs. Mem. Cogn. 2009, 37, 447–463. [Google Scholar] [CrossRef] [PubMed]
  85. Morgan, C.; Gayer-Anderson, C. Childhood adversities and psychosis: Evidence, challenges, implications. World Psychiatry 2016, 15, 93–102. [Google Scholar] [CrossRef] [PubMed]
  86. Quek, Y.-H.; Tam, W.W.S.; Zhang, M.W.B.; Ho, R.C.M. Exploring the association between childhood and adolescent obesity and depression: A meta-analysis. Obes. Rev. 2017, 18, 742–754. [Google Scholar] [CrossRef] [PubMed]
  87. Lu, Y.; Ho, R.; Lim, T.K.; Kuan, W.S.; Goh, D.Y.T.; Mahadevan, M.; Sim, T.B.; Ng, T.-P.; van Bever, H.P.S. Psychiatric Comorbidities in Asian Adolescent Asthma Patients and the Contributions of Neuroticism and Perceived Stress. J. Adolesc. Health 2014, 55, 267–275. [Google Scholar] [CrossRef] [PubMed]
  88. Chernyshov, P.V.; Ho, R.C.; Monti, F.; Jirakova, A.; Velitchko, S.S.; Hercogova, J.; Neri, E. An International Multi-center Study on Self-assessed and Family Quality of Life in Children with Atopic Dermatitis. Acta Dermatovenerol. Croat. 2015, 23, 247. [Google Scholar] [PubMed]
  89. Ho, R.C.M.; Giam, Y.C.; Ng, T.P.; Mak, A.; Goh, D.; Zhang, M.W.B.; Cheak, A.; Van Bever, H.P. The influence of childhood atopic dermatitis on health of mothers, and its impact on Asian families. Pediatr. Allergy Immunol. 2010, 21, 501–507. [Google Scholar] [CrossRef] [PubMed]
  90. Tran, B.X.; Huong, L.T.; Hinh, N.D.; Nguyen, L.H.; Le, B.N.; Nong, V.M.; Thuc, V.T.M.; Tho, T.D.; Latkin, C.; Zhang, M.W.; et al. A study on the influence of internet addiction and online interpersonal influences on health-related quality of life in young Vietnamese. BMC Public Health 2017, 17, 138. [Google Scholar] [CrossRef] [PubMed]
Table 1. Odds ratio (OR) depending on the different dependent variables studied (Mental Health Problems, Internalizing Problems, Externalizing Problems) and gender.
Table 1. Odds ratio (OR) depending on the different dependent variables studied (Mental Health Problems, Internalizing Problems, Externalizing Problems) and gender.
SDQGender% ProblemsRateχ2pOR95% CI
Mental Health ProblemsGirls14.20.38218.421<0.0012.1991.5273.166
Boys26.70.618
Internalizing ProblemsGirls19.10.4941.4950.2211.2440.8761.767
Boys22.70.506
Externalizing ProblemsGirls15.10.36526.456<0.0012.4841.7463.535
Boys30.70.635
SDQ = Strengths and Difficulties Questionnaire. Rate = proportion of different gender categories with presence of mental health problems.
Table 2. Results of the logistic regression analysis for the prediction of Mental Health Problems (Total SDQ) Internalizing Problems and Externalizing Problems in girls and boys.
Table 2. Results of the logistic regression analysis for the prediction of Mental Health Problems (Total SDQ) Internalizing Problems and Externalizing Problems in girls and boys.
SDQ Factors aBSEWalddfSig.Exp(B)95% CI
TotalGirlsAffection and Communication Father−0.5690.5291.15510.2820.5660.2011.597
Criticism and Rejection Father1.7380.43216.21210.0005.6842.43913.243
Affection and Communication Mother0.1100.4940.05010.8241.1160.4242.941
Criticism and Rejection Mother−0.3670.4690.61410.4330.6920.2761.736
Constant−2.0600.21889.55710.0000.127
BoysAffection and Communication Father0.3420.4180.66910.4131.4070.6213.192
Criticism and Rejection Father0.1560.4210.13810.7101.1690.5132.667
Affection and Communication Mother0.7910.3884.15210.0522.2051.0314.716
Criticism and Rejection Mother1.0830.3957.53010.0062.9521.3636.397
Constant−1.5750.18077.01210.0000.207
Internalizing ProblemsGirlsAffection and Communication Father−0.6930.4542.32410.1270.5000.2051.219
Criticism and Rejection Father1.8050.41219.21310.0006.0782.71213.622
Affection and Communication Mother0.3990.4240.88810.3461.4910.6503.419
Criticism and Rejection Mother−0.4260.4470.90810.3410.6530.2721.569
Constant−1.7160.19279.91610.0000.180
BoysAffection and Communication Father0.6680.4322.39110.1221.9500.8364.547
Criticism and Rejection Father0.2450.4340.32010.5721.2780.5462.991
Affection and Communication Mother0.1940.4220.21210.6451.2140.5312.776
Criticism and Rejection Mother0.9200.4095.05910.0252.5091.1265.591
Constant−1.7150.18783.65410.0010.180
Externalizing ProblemsGirlsAffection and Communication Father−0.1950.4370.19910.6560.8230.3501.937
Criticism and Rejection Father0.2440.4600.28210.5951.2770.5193.142
Affection and Communication Mother0.4780.4251.26510.2611.6120.7013.707
Criticism and Rejection Mother0.5380.4651.34310.2471.7130.6894.258
Constant−1.9470.20689.07810.0000.143
BoysAffection and Communication Father0.5420.4071.77310.1831.7190.7743.818
Criticism and Rejection Father0.4020.4080.96710.3251.4940.6713.328
Affection and Communication Mother0.4520.3851.38110.2401.5720.7393.341
Criticism and Rejection Mother0.9460.3826.14110.0132.5751.2195.442
Constant−1.3540.16864.86810.0000.258
a Reference category is ‘no’; B = Unstandardized beta coefficient; SE = standard error; df= Degrees of freedom.

Share and Cite

MDPI and ACS Style

León-del-Barco, B.; Fajardo-Bullón, F.; Mendo-Lázaro, S.; Rasskin-Gutman, I.; Iglesias-Gallego, D. Impact of the Familiar Environment in 11–14-Year-Old Minors’ Mental Health. Int. J. Environ. Res. Public Health 2018, 15, 1314. https://doi.org/10.3390/ijerph15071314

AMA Style

León-del-Barco B, Fajardo-Bullón F, Mendo-Lázaro S, Rasskin-Gutman I, Iglesias-Gallego D. Impact of the Familiar Environment in 11–14-Year-Old Minors’ Mental Health. International Journal of Environmental Research and Public Health. 2018; 15(7):1314. https://doi.org/10.3390/ijerph15071314

Chicago/Turabian Style

León-del-Barco, Benito, Fernando Fajardo-Bullón, Santiago Mendo-Lázaro, Irina Rasskin-Gutman, and Damián Iglesias-Gallego. 2018. "Impact of the Familiar Environment in 11–14-Year-Old Minors’ Mental Health" International Journal of Environmental Research and Public Health 15, no. 7: 1314. https://doi.org/10.3390/ijerph15071314

APA Style

León-del-Barco, B., Fajardo-Bullón, F., Mendo-Lázaro, S., Rasskin-Gutman, I., & Iglesias-Gallego, D. (2018). Impact of the Familiar Environment in 11–14-Year-Old Minors’ Mental Health. International Journal of Environmental Research and Public Health, 15(7), 1314. https://doi.org/10.3390/ijerph15071314

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop