Patterns of Self-Reported Alcohol Use,Depressive Symptoms,and Body Mass Index in a Family Sample: The Buffering Effects of Parentification

Abstract

Although the impact of parentification on children and adolescents’ psychological health and outcomes has long been studied and well documented, little is known about the impact of parentification on children and adolescents’ physical health and medical outcomes. Moreover, the potential buffering effects of parentification have been examined very rarely. The data in the current study were collected from an understudied, high-priority adolescent population (N = 51 rural adolescent–parent dyads). The authors examined the bivariate relations between parent health (alcohol use, depressive symptoms, and body mass index [BMI]), adolescent health (alcohol use, depressive symptoms, and BMI), and parentification. The effect size of the significant bivariate correlations ranged from small to large (r = .29 to r = .62). Parentification was positively associated with parent BMI and adolescent depressive symptoms. Parent alcohol use was strongly associated with adolescent alcohol use. Regression analyses were performed to determine if parentification moderates the relation between parental health and adolescent health. Parentification was found to function as a buffer of the relation between parent alcohol use and adolescent alcohol use. Parentification did not function as a moderator of the relation between parent depressive symptoms and adolescent depressive symptoms nor in the relationship between parent BMI and adolescent BMI. However, parentification did moderate the association between parent alcohol use and adolescent depressive symptoms.

Keywords

parentification alcohol use depressive symptoms body mass index parental health adolescent health tests of moderation health risk factors

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References

Aiken

West

S. G.

(1991). Multiple regression testing and interpreting interactions. Newbury Park, CA: Sage.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental health disorders (4th ed.). Washington, DC: Author.

Babor

T. F.

Higgins-Biddle

J. C.

Saunders

J. B.

Monteiro

M. G.

(2001). AUDIT: The alcohol use disorders identification test: Guidelines for use in primary care (2nd ed.). Geneva, Switzerland: World Health Organization.

Banks

Cogan

N. A.

Deeley

Hill

Riddell

Tisdall

E. K. M.

(2001). Seeing the invisible children and young people affected by disability. Disability and Society, 16, 797–814.

Barber

B. K.

(1996). Parental psychological control: Revisiting a neglected construct. Child Development, 67, 3296–3319.

Barber

B. K.

(Ed.). (2001). Intrusive parenting: How psychological control affects children and adolescents. Washington, DC: American Psychological Association.

Beck

A. T.

Steer

R. A.

Brown

G. K.

(1996). BDI-II manual. San Antonio, TX: Psychological Corporation.

Bekir

McLellan

Childress

A. R.

Gariti

(1993). Role reversals in families of substance abusers: A transgenerational phenomenon. International Journal of the Addictions, 28, 613–630.

Boszormenyi-Nagy

Spark

(1973). Invisible loyalties: Reciprocity in intergenerational family therapy. Hagerstown, MD: Harper & Row.

10.

Bowen

(1978). Family therapy in clinical practice. New York, NY: Jason Aronson.

11.

Bowlby

(1969). Attachment and loss: Vol. 1. Attachment. New York, NY: Basic.

12.

Burton

(2007). Childhood adultification in economically disadvantaged families: A conceptual model. Family Relations, 56, 329–345.

13.

Byng-Hall

(2008a). The crucial roles of attachment in family therapy. Journal of Family Therapy, 30, 129–146.

14.

Byng-Hall

(2008b). The significance of children fulfilling parental roles: Implications for family therapy. Journal of Family Therapy, 30, 147–162.

15.

Byrne

B. M.

Stewart

S. M.

Kennard

B. D.

Lee

P. W. H.

(2007). The Beck Depression Inventory-II: Testing measurement equivalence and factor mean differences across Hong Kong and American adolescents. International Journal of Testing, 7, 293–209.

16.

Carmody

D. P.

(2005). Psychometric properties of the Beck Depression Inventory-II with college students of diverse ethnicity. International Journal of Psychiatry of Clinical Practice, 9, 22–28.

17.

Carroll

J. J.

Robinson

B. E.

(2000). Depression and parentification among adults as related to parental workaholism and alcoholism. The Family Journal, 8, 360–367.

18.

Centers for Disease Control and Prevention. (n.d.). About BMI for children and teens. Retrieved from http://www.cdc.gov/healthyweight/assessing/bmi/childrenbmi/aboutchildrensbmi.html

19.

Centers for Disease Control and Prevention. (2006a). Obesity still a major problem. Retrieved from http://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htm

20.

Centers for Disease Control and Prevention. (2006b). Prevalence of overweight among children and adolescents: United States, 2003-2004. Retrieved from http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm

21.

Centers for Disease Control and Prevention. (2009). CDC’s youth behavior surveillance system. Washington, DC: Author.

22.

Champion

J. E.

Jaser

S. S.

Reeslund

K. L.

Simmons

Potts

J. E.

Shears

A. R.

Compas

B. E.

(2009). Caretaking behaviors by adolescent children of mothers with and without a history of depression. The role of caretaking in children of mothers with a history of depression. Journal of Family Psychology, 23, 156–166.

23.

Chase

(1999). An overview of theory, research, and societal issues. In Chase

(Ed.), Burdened children (pp. 3–33). New York, NY: Guilford Press.

24.

Chase

Demming

Wells

(1998). Parentification, parental alcoholism, and academic status among young adults. American Journal of Family Therapy, 25, 105–114.

25.

Cohen

(1992). A power primer. Psychological Bulletin, 112, 155–159.

26.

Cohen

(1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

27.

Davis

H. D.

Gergen

P. J.

(1994). The weights and heights of Mexican-American adolescents: The accuracy of self-reports. American Journal of Public Health, 84, 459–462.

28.

DeCoster

Gallucci

Iselin

A. R.

(2011). Best practices for using median splits, artificial categorization, and their continuous alternatives. Journal of Experimental Psychopathology, 2, 197–209.

29.

Diener

Emmons

R. A.

Larsen

R. J.

Griffin

(1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.

30.

Dozois

D. J. A.

Dobson

K. S.

Ahnberg

J. L.

(1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 83–89.

31.

Duryea

M. M.

(2007). Mothers with chronic physical illness and the parentification of their children (Doctoral dissertation). Retrieved from ProQuest database (AAT 3298190).

32.

Earley

Cushway

Cassidy

(2007). Children’s perceptions and experiences of care giving: A focus group study. Counselling Psychology Quarterly, 20, 69–80. doi:10.1080/09515070701217830

33.

East

P. L.

(2010). Children’s provision of family caregiving: Benefit or burden? Child Development Perspectives, 4, 55–61.

34.

East

P. L.

Weisner

T. S.

(2009). Mexican American adolescents’ family caregiving: Selection effects and longitudinal associations with adjustment. Family Relations, 58, 562–577.

35.

Field

A. E.

Coakley

E. H.

Must

Spadano

J. L.

Laird

Dietz

W. H.

Colditz

G. A. (2001). Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Archives of Internal Medicine, 161, 1581–1586.

36.

Fischer

J. L.

Forthun

L. F.

Pidcock

B. W.

Dowd

D. A.

(2007). Parent relationships, emotion regulation, psychosocial maturity and college student alcohol use problems. Journal of Youth and Adolescence, 36, 912–926. doi:10.1007/s10964-006-9126-6

37.

Garber

B. D.

(2011). Parental alienation, and the dynamics of the enmeshed parent-child dyad: Adultification, parentification, and infantilization. Family Court Review, 49, 322–335.

38.

Gary

F. A.

Yarandi

H. N.

(2004). Depression among southern rural African American women. Nursing Research, 53, 251–259.

39.

Gates

M. F.

Lackey

N. R.

(1998). Youngsters caring for adults with cancer. Journal of Nursing Scholarship, 30, 11–15.

40.

Gelman

C. R.

Greer

(2011). Young children in early-onset Alzheimer’s disease families: Research gaps and emerging service needs. American Journal of Alzheimer’s Disease and Other Dementias, 26, 29–35.

41.

Godsall

R. E.

Jurkovic

G. J.

(1995). Parentification questionnaire—youth. Atlanta, GA: G. J. Jurkovic, Department of Psychology, Georgia State University, University Plaza.

42.

Godsall

R. E.

Jurkovic

G. J.

Emshoff

Anderson

Stanwyck

(2004). Why some kids do well in bad situations: Relation of parental alcohol misuse and parentification to children’s self-concept. Substance Use & Misuse, 39, 789–809. doi:10.1081/JA-120034016

43.

Goglia

Jurkovic

Burt

Burge-Callaway

(1992). Generational boundary distortions by adult children of alcoholics: Child-as-parent and child-as-mate. American Journal of Family Therapy, 20, 291–299.

44.

Hill

T. D.

Burdette

A. M.

Weiss

M. L.

Chitwood

D. D.

(2009). Religious involvement and adolescent substance use. In Leukefeld

C. G.

Gullotta

T. P.

Staton-Tindall

(Eds.), Adolescent substance abuse: Evidence-based approaches to prevention and treatment (pp. 171–189). New York, NY: Springer.

45.

Hooper

L. M.

(2007a). The application of attachment theory and family systems theory to the phenomena of parentification. The Family Journal, 15, 217–223. doi:10.1177/1066480707301290

46.

Hooper

L. M.

(2007b). Expanding the discussion regarding parentification and its varied outcomes: Implications for mental health research and practice. Journal of Mental Health Counseling, 29, 322–337.

47.

Hooper

L. M.

(2011). Parentification. In Levesque

R. J. R.

(Ed.), Encyclopedia of adolescence (Vol. 4, pp. 2023–2031). New York, NY: Springer.

48.

Hooper

L. M.

DeCoster

White

Voltz

M. L.

(2011). Characterizing the magnitude of the relation between self-reported childhood parentification and adult psychopathology: A meta-analysis. Journal of Clinical Psychology, 67, 1028–1043.

49.

Hooper

L. M.

Marotta

S. A.

DePuy

(2009). A confirmatory factor analytic study of the Posttraumatic Growth Inventory among a sample of racially diverse college students. Journal of Mental Health, 18, 335–343. doi:10.1080/09638230802522502

50.

Hooper

L. M.

Marotta

S. A.

Lanthier

R. P.

(2008). Predictors of growth and distress following parentification among college students. Journal of Child and Family Studies, 17, 693–705.

51.

Hooper

L. M.

Newman

C. R.

(2011). Exploring the relations between parent depressive symptoms, family religious involvement, and adolescent depressive symptoms: A test of moderation. Counseling and Values, 55, 210–227.

52.

Hooper

L. M.

Wallace

(2010). Evaluating the parentification questionnaire: Psychometric properties and psychopathology correlates. Contemporary Family Therapy: An International Journal, 32, 52–68.

53.

Institute of Medicine. (2011). Healthy people 2020: Leading health indicators. Washington, DC: National Academies Press.

54.

Ireland

M. J.

Pakenham

K. I.

(2010a). The nature of youth care tasks in families experiencing chronic illness/disability: Development of the youth activities of caregiving scale (YACS). Psychology & Health, 25, 713–731. doi:10.1080/08870440902893724

55.

Ireland

M. J.

Pakenham

K. I.

(2010b). Youth adjustment to parental illness or disability: The role of illness characteristics, caregiving, and attachment. Psychology, Health & Medicine, 15, 632–645.

56.

Johnston

J. R.

(1990). Role diffusion and role reversal: Structural variations in divorced families and children’s functioning. Family Relations, 39, 405–413.

57.

Jones

J. W.

(1983). The children of alcoholics screening test and test manual. Chicago, IL: Camelot Unlimited.

58.

Jurkovic

G. J.

(1997). The plight of the parentified child. New York, NY: Brunner Mazel.

59.

Jurkovic

G. J.

(1998). Destructive parentification in families: Causes and consequences. In L’Abate

(Ed.), Family psychopathology (pp. 237–255). New York, NY: Guilford Press.

60.

Jurkovic

G. J.

Casey

(2000, March). Parentification in immigrant Latino adolescents. In Kuperminc

G. P.

(Chair), Proyecto juventud: A multidisciplinary study of immigrant Latino adolescents. Symposium conducted at the meeting of the Society for Applied Anthropology, San Francisco, CA.

61.

Jurkovic

G. J.

Morrell

Casey

(2001). Parentification in the lives of high-profile individuals and their families: A hidden source of strength and distress. In Robinson

B. E.

Chase

N. D.

(Eds.), High performing families: Causes, consequences, and clinical solutions (pp. 129–155). Alexandria, VA: American Counseling Association.

62.

Jurkovic

G. J.

Morrell

Thirkield

(1999). Assessing childhood parentification: Guidelines for researchers and clinicians. In Chase

(Ed.), Burdened children (pp. 92–113). New York, NY: Guilford Press.

63.

Jurkovic

G. J.

Thirkield

Morrell

(2001). Parentification of adult children of divorce: A multidimensional analysis. Journal of Youth Adolescence, 30, 245–257.

64.

Kam

(2011). The effects of language brokering frequency and feelings of Mexican-heritage youth’s mental health and risky behavior. Journal of Communication, 61, 455–475.

65.

Kelley

M. L.

French

Bountress

Keefe

H. A.

Schroeder

Steer

Gumienny

(2007). Parentification and family responsibility in the family of origin of adult children of alcoholics. Addictive Behaviors, 32, 675–685. doi:10.1016/j.addbeh.2006.06.010

66.

Kerig

P. K.

(2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5–42.

67.

Kutner

M. H.

Nachtsheim

C. J.

Neter

(2004). Applied linear regression models (4th ed.). New York, NY: McGraw-Hill Irwin.

68.

Luecken

L. J.

Lemery

K. S.

(2004). Early caregiving and physiological stress responses. Clinical Psychology Review, 24, 171–191.

69.

Macfie

McElwain

N. L.

Houts

R. M.

Cox

M. J.

(2005). Intergenerational transmission of role reversal between parent and child: Dyadic and family systems internal working models. Attachment & Human Development, 7, 51–65. doi:10.1080/14616730500039663

70.

Minuchin

Montalvo

Guerney

Rosman

Schumer

(1967). Families of the slums. New York, NY: Basic Books.

71.

Must

Spadano

Coakley

E. H.

Field

A. E.

Colditz

Dietz

W. H.

(1999). The disease burden associated with overweight and obesity. Journal of the American Medical Association, 282, 1593–1594.

72.

Nielsen

(2011). Divorced fathers and their daughters: A review of recent research. Journal of Divorce & Remarriage, 52, 77–93.

73.

Osman

Guiterrez

P. M.

Wong

J. L.

Freedenthal

Bagge

C. L.

Smith

K. D.

(2008). Psychometric properties of the Beck Depression Inventory-II in nonclinical adolescent samples. Journal of Clinical Psychology, 64, 83–102.

74.

Pakenham

K. I.

Bursnall

Chiu

Cannon

Okochi

(2006). The psychosocial impact of caregiving on young people who have a parent with an illness or disability: Comparisons between young caregivers and noncaregivers. Rehabilitation Psychology, 51, 113–126. doi:10.0137/0090-5550.51.2.113

75.

Pakenham

K. I.

Chiu

Bursnall

Cannon

(2007). Relations between social support, appraisal and coping and both positive and negative outcomes in young carers. Journal of Health Psychology, 12, 89–102. doi:10.1177/1359105307071743

76.

Preacher

K, J.

Rucker

D. D.

Hayes

A. F.

(2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42, 185–227.

77.

Reeves

G. M.

Postolache

T. T.

Snitker

(2008). Childhood obesity and depression: Connection between these growing problems in growing children. International Journal on Disability and Human Development, 1, 103–114.

78.

Sahoo

Suar

(2010). The influence of social environment on young carers, assistance and consequences of caregiving. Psychological Studies, 55, 323–329.

79.

Sessions

M. W.

Jurkovic

G. J.

(1986). The parentification questionnaire. Atlanta, GA: Jurkovic

Gregory J.

, Department of Psychology, Georgia State University, University Plaza.

80.

Shifren

(2001). Early caregiving and adult depression: Good news for young caregivers. The Gerontologist, 41, 188–190.

81.

Shifren

Kachorek

L. V.

(2003). Does early caregiving matter? The effects on young caregiver's adult mental health. International Journal of Behavioral Development, 27, 338–346. doi:10.1080/01650250244000371

82.

Simons

J. S.

Carey

K. B.

Gaher

R. M.

(2004). Lability and impulsivity synergistically increase risk for alcohol-related problems. American Journal of Drug and Alcohol Abuse, 30, 685–694. doi:10.1081/ADA-200032338

83.

Sroufe

L. A.

Ward

M. J.

(1980). Seductive behavior of mothers of toddlers: Occurrence, correlates, and family origins. Child Development, 51, 1222–1229.

84.

Steer

R. A.

Clark

D. A.

(1997). Psychometric properties of the Beck Depression Inventory-II with college students. Measurement and Evaluation in Counseling and Development, 30, 128–137.

85.

Stein

J. A.

Riedel

Rotheram-Borus

M. J.

(1999). Parentification and its impact on adolescent children of parents with AIDS. Family Process, 38, 193–208. doi:10.1111/j.1545-5300.1999.00193.x

86.

Stein

J. A.

Rotheram-Borus

M. J.

Lester

(2007). Impact of parentification on long-term outcomes among children of parents with HIV/AIDS. Family Process, 46, 317–333. doi:10.1111/j.1545-5300.2007.00214.x

87.

Storch

E. A.

Roberti

J. W.

Roth

D. A.

(2004). Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory-Second edition in a sample of college students. Depression and Anxiety, 19, 187–189.

88.

Strauss

R. S.

(1999). Self-reported weight status and dieting in a cross-sectional sample of young adolescents. Archives of Pediatric Adolescent Medicine, 153, 741–747.

89.

Stunkard

A. J.

Faith

M. S.

Allison

K. C.

(2003). Depression and obesity. Society of Biological Psychiatry, 54, 330–337.

90.

Svanberg

(2010). Recognising the needs of children of younger people with dementia. Journal of Dementia Care, 18, 35–37.

91.

Tedeschi

R. G.

Calhoun

L. G.

(1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.

92.

Telzer

E. H.

Fuligni

A. J.

(2009). Daily family assistance and the psychological well-being of adolescents from Latin American, Asian, and European backgrounds. Developmental Psychology, 45, 1177–1189.

93.

Tienboon

Wahlqvist

M. L.

Rutishauser

I. H. E.

(1992). Self-reported weight and height in adolescents and their parents. Society for Adolescent Medicine, 13, 528–532.

94.

Vernig

P. M.

(2011). Family roles in homes with alcohol-dependent parents: An evidence-based review. Substance Use & Misuse, 46, 535–542.

95.

Walker

J. P.

Lee

R. E.

(1998). Uncovering strengths of children of alcoholic parents. Contemporary Family Therapy, 20, 521–533.

96.

Walker

Ainette

M. G.

Wills

T. A.

Mendoza

(2007). Religiosity and substance use: Test of an indirect-effect model in early and middle adolescence. Psychology of Addictive Behaviors, 21, 84–96. doi:10.1037/0893-164X.21.1.84

97.

Walsh

(1998). Strengthening family resilience. New York, NY: Guildford Press.

98.

Ward

L. C.

(2006). Comparison of factor structure models for the Beck Depression Inventory-II. Psychological Assessment, 18, 81–88.

99.

Zeanah

C. H.

Zeanah

P. D.

(1989). Intergenerational transmission of maltreatment: Insights from attachment theory and research. Psychiatry, 52, 177–196.