The association of parenting style on depression, anxiety and stress among Tamil speaking adolescents in the Colombo city

Introduction: Globally, studies have identified varied associations between the four key parenting styles and adolescent depression, anxiety and stress. However, such studies are rare in Sri Lanka, especially among Tamil speaking adolescents. Objective: To assess the association between perceived parenting style on depression, anxiety and stress among Tamil speaking adolescents in the Colombo city. Method: A cross sectional study design was used with a sample of 232, 15to 18-year-old adolescents attending government schools in the Colombo city, chosen through a stratified random sampling technique. The Scale of Parenting Style and the Depression Anxiety and Stress Scale-21 were used along with a demographic questionnaire. The standardized scales showed good validity and reliability properties amongst the Sri Lankan Tamil speaking population. Results: Authoritative parenting style was associated with a lower level of depression when compared to neglectful parenting style (p= 0.000134, p<0.001). Likewise, authoritative parenting style was associated with a lower level of stress when compared to neglectful parenting style (p=0.001713, p<0.01). However, amongst these two parenting styles, there was no impact on adolescent anxiety (p=0.05176, p>0.05). Further, as the parents’ controlling behaviour increased, it had a negative significant association with depression (r= -0.26, p= 0.000048), anxiety (r= -0.13, p=0.0453) and stress (r= -0.19, p= 0.00289). And, as parental responsiveness towards the adolescent increased, it had a significant negative association with _________________________________________ Faculty of Graduate Studies, University of Colombo, Department of Psychiatry, Faculty of Medicine, University of Colombo *Correspondence: ptdz@sltnet.lk (Received on 02 March 2018: Accepted after revision on 20 April 2018) The authors declare that there are no conflicts of interest Personal funding was used for the project. Open Access Article published under the Creative Commons Attribution CC-BY License depression (r= -0.28, p= 0.000014), anxiety, (r= 0.2, p=0.00248) and stress, (r= -0.26, p=0.000049). Conclusions: The study indicates that certain parenting styles have a significant impact on adolescent depression, anxiety and stress. The authoritative parenting style was identified as the most favourable whereas the neglectful parenting style was identified as the worst. DOI: http://dx.doi.org/10.4038/sljch.v47i4.8597 (


Introduction
As the family is the primary base where the development of most human beings begin, parenting is considered a vital factor in the psychological wellbeing of an adolescent 1 .Parenting is defined as the constellation of attitudes a parent shows to the child, that are communicated to the child, and that taken together, create an emotional climate in which parental behaviours are expressed 2 .Literature cites four parenting styles: authoritative, authoritarian, permissive and neglectful.These four styles are defined based on two qualities: warmth and control.Warmth is defined as the level of responsiveness and acceptance the parent shows to the needs and wants of the child.Control is defined as the management of the child's behaviour -by imposing strict rules, or fewer rules than is required, or not imposing any rules at all 2,3 .In the authoritarian parenting style, choices and rules are made for children, with no warmth and love.Children are allowed to make their own choices and rules, with excessive love, when parents use the permissive parenting style.Parents, who are authoritative, guide children in terms of making rules and following these rules whilst providing an adequate amount of love and warmth.Neglectful parenting style is associated with neither warmth nor control.Of these four parenting styles, authoritative parenting is considered the healthiest and that which produces positive outcomes.Authoritarian parenting style is considered the unhealthiest and that which produces a host of negative outcomes 2,3 .
Outside of Sri Lanka, the impact of parenting styles on depression, anxiety and stress has been studied thoroughly and has been concluded to play a role in mental health outcomes.Some of the more important such mental health outcomes would be depression, anxiety and stress.Though some studies on depression indicate that authoritarian parenting produces more depression 4 , other studies conclude that neglectful parenting style produces a higher level of depression than the former 5 .On the other hand, permissive parenting style and authoritative parenting styles are associated with lower levels of depression 5,6 .In fact, this prolonged benefit of the authoritative parenting style is evident in longitudinal studies.For instance, individuals who experienced authoritative parenting during adolescence exhibited very minimal symptoms of depression, even in adulthood 6 .With regards to anxiety, the authoritarian parenting style has shown a positive association with its development, whereas the authoritative style has shown a negative association 7 .In the purview of stress, studies have displayed mixed results.An association between parenting style and adolescent stress is indicated in one Asian study 8 , whereas other studies indicated no such association 9 .
A few studies indicate that the relationship between parenting styles and psychological ill-health -such as depression, anxiety, and stress -is similar across cultures and countries 10 whereas other studies point out cross cultural differences 11 .This difference is attributed to the perception of adolescents whereby, the way they perceive their parents' parenting style differs across cultures, regardless of the similarity in the parenting style per se 12,13 .Though most studies had concluded that authoritarian parenting was the worst and authoritative the best, the impact of this perception has only been identified later on.In this context, positive outcomes of authoritarian parenting style were mostly observed among those of Asian descent 13 .Moreover, the authoritarian parenting style, in an authoritarian culture, does not appear to lead to psychological ill-health in adolescents 14 .One reason for the above finding could be that Asian adolescents perceive authoritarian style as parental caring, concern and involvement.On the other hand, Caucasians adolescents perceive it as parental dominance, aggression and hostility 13 .
The present study intended to investigate the perceived parenting styles and its association with selected mental health outcomes of depression, anxiety, and stress among Tamil speaking adolescents attending government schools in the Colombo city.As this is the first known study on parenting styles and selected mental health outcomes among Tamil speaking adolescents, it is envisaged that this study would enlighten the crosscultural dynamics of this area of parent-child relationship.

Objective
To assess the association between perceived parenting style on depression, anxiety and stress among Tamil speaking adolescents in the Colombo city.

Method
Sample size was calculated as 232.This was based on Guilford, Frunchter & Benjamins' (1978) formula, as the size needed for MANOVA with four groups (i.e.four parenting types) to test mental health outcomes of depression, anxiety and stress with a moderate effect size, power of 0.80, and an alpha of 0.05.A cross sectional study design was used, chosen through a stratified random sampling technique (see Figure 1).
All 15-to 18-year-old Tamil speaking adolescents in government schools in the Colombo city were considered, regardless of whether they were from a unilingual, bilingual or trilingual school.This age group was chosen as there is a statistically heightened level of suicidal attempts in the 15-to 19year-old age group 1 , and hence the authors considered this age group an important period to study in relation to parenting styles.Nineteen-yearolds were not included however, as they were on study leave during the study duration.Adolescents with single parents were excluded as this study intended to analyse the parenting styles of the father and mother separately and their combined parenting style.They were not discriminated at the data collection phase but their information was not included in the statistical analysis.
Two standardized measurement scales were used in addition to the demographic questionnaire.The scale that assessed the style of parenting -The Scale of Parenting Style -was content and consensual validated as a part of a larger study.It was chosen over other parenting scales as its original version was based on a Tamil speaking population in India, and hence the authors deemed it had greater relevance to Sri Lanka.The scale that assessed depression, anxiety and stress -The Depression Anxiety and Stress Scale-21 (DASS-21) -had already been validated to the Tamil speaking population in Sri Lanka 14 .Both scales indicated good psychometric properties 14 .The selfadministered Scale of Parenting Styles has 38 items, divided into two sub scales: 19 items measure parental warmth and 19 items measure parental control.Participants are required to rate their mothers and fathers on a Likert scale from one (always false) to five (always true).The selfadministered DASS -21 contains 21 items.It has seven items on depression, seven items on anxiety and seven items on stress.The referent time period is the week previous to the administration of the scale.A Likert scale from zero (did not apply to me at all) to three (applied to me very much or most of the time) is used to rate each item.The scores on each factor is multiplied by two and categorized as "normal" to "extremely severe" based on the DASS-21 manual.
After obtaining their consent, the three scales (i.e.demographic questionnaire (based on Table 1), DASS-21 and the Scale of Parenting Styles) were administered to the participants.An introduction was given to the participants along with the instructions on how to complete the scales.Tokens of appreciation -a pen and books marks that contain wordings of positive mental health -were provided during the process of finishing the data collection.
Approval for the study was obtained from the Ministry of Education and the principals of the schools.The Ethical Review Committee of the Faculty of Graduate Studies of the University of Colombo approved the study.

Results
Demographic characteristics of the adolescent study sample are shown in Table 1.Parenting style had a significant association with depression (p=0.0002),anxiety (p=0.045) and stress (p=0.0015).Amongst the four styles of parenting, authoritative parenting style was associated with lower level of depression and stress whereas neglectful parenting style was associated with higher level of depression and stress.However, amongst these two types of parenting styles, there was no impact of parenting style on adolescent anxiety The impact of the parenting style of the mother and father was analysed separately, which indicated a significant difference for depression (p=0.0004 and p=0.0016) and stress (p=0.0013 and p=0.0004).However, the mother's parenting styles had a significant effect on anxiety (p=0.0027)whereas father's parenting styles did not (p=0.153).
Similarly, in the case of combined style of parenting, authoritative parenting style of mothers and fathers were associated with lower level of depression and stress in adolescents whereas neglectful parenting style of mothers and fathers were associated with higher level of depression and stress.

Discussion
The present study aimed to assess the association between perceived parenting style and depression, anxiety and stress among Tamil speaking adolescents attending government schools in the Colombo city.Just as previous studies have concluded that there is an association between parenting styles and psychological ill-health of adolescents 15 , the present study too indicated that certain parenting styles had a significant impact on adolescent depression, anxiety and stress.
A key finding of the present study was that, amongst the four parenting styles studied, the authoritative parenting style was associated with a lower level of depression whereas the neglectful parenting style was associated with a higher level of depression, despite the gender of the parents.This finding has been corroborated by a previous study 5 too.The absence of warmth and (healthy) control in this style of parenting is considered to have negative mental health consequences such as depression 5 .
Parenting style plays a pivotal role in predicting anxiety among adolescents too.For instance, a previous study concluded that authoritarian parenting style is positively associated with the development of anxiety, whereas the authoritative style has a negative association 7 .The present study corroborates this finding on authoritative parenting style (of mothers) leading to a lower level of adolescent anxiety.On the other hand, this study indicated that mothers' neglectful parenting style leads to a higher level of anxiety in adolescents.However, parenting styles of fathers did not have a significant effect on anxiety among adolescents.The authors opine that because fathers may not spend as much time as mothers on day-to-day parenting activities, parent-to-child transference of anxiety may be from mothers rather than fathers.Future research could explore the validity of this hypothesis.
Previous studies on parenting styles and stress have displayed mixed results.For instance, although a study concluded that there was no association between parenting styles and stress 9 , an Asian study did indicate an association between these two variables 8 .The latter was evident in the present study too where parenting style had a significant impact on adolescent stress.Amongst all four styles of parenting, authoritative parenting style was associated with lower levels of stress whereas neglectful parenting style was associated with the highest level of stress.This finding could be because authoritative parenting lends structure to the adolescent' life as well as parental warmth, which has a positive impact on their mental well-being.However, being neglectful, adolescents of such parents would experience more stress and hence have higher mental ill-health conditions.
With regards to the two components that make-up different parenting styles (i.e.warmth and control) previous studies have indicated that parental warmth is negatively associated with depression 16 and anxiety 17 whereas parental control is positively associated with depression 18 and anxiety 19 .Moreover, some cross-cultural studies have indicated that the impact of parental control is similar across cultures where the positive association between parental control and symptoms of psychological ill-health are not limited to Western countries but is applicable to Asian countries as well 10 .However, contrary to the result of these cross-cultural studies 10 , the present study's finding indicated that parental control did not lead to adolescent depression, anxiety and stress in the Sri Lankan context.It could be that Sri Lankan Tamil speaking adolescents perceive parental control as an indication of love and care, hence buffering any negative mental health impact of it.Future research could explore the validity of this hypothesis.
In summary, of the four parenting styles studied, the authoritative parenting style was identified as the most favourable whereas the neglectful parenting style was identified as the worst.The authors hypothesise that because adolescents may perceive parental involvement in their lives as a positive occurrence, neglectful parenting style -which involves minimal parental involvement -could have led to the finding of higher levels of adolescent depression, anxiety and stress.Moreover, authoritative parenting style would have been perceived as the most positive out of the four parenting styles because parental involvement is higher in this style, in terms of warmth and control.Permissive parenting style and authoritarian parenting style lack in at least one of these components of warmth and control 3 .The absence of one or both these components may lead to mental health problems among adolescents as they do not get adequate level of support and attention from parents to deal with their burgeoning needs, wants and difficulties.
This study was not without limitations.One such limitations was that the four parenting styles studied 2,3 were obtained from research done among an American middle-class population.These four parenting styles may or may not be applicable to Sri Lanka.Or, there may be other parentings styles in the country.Another limitation was that only selected correlates were studied in the present research.This was due to time and resource limitations.Further, multiple confounding factors relevant to adolescent mental health were not considered in this study either.Future studies may address these limitations.
The results obtained from the present study could be applicable to other ethnicities in Sri Lanka too, since the social norms are similar across ethnicities in Sri Lanka 18 .Though skilful parenting programs are common in Western countries, it is not so in Sri Lanka.These study findings could inform culturally-informed parenting programmes in the country.

Conclusions
The authoritative parenting style was identified as the best parenting style whereas the neglectful parenting style was identified as the worst parenting style, as perceived by Tamil speaking government school adolescents in the Colombo city.