PARENTAL DISCIPLINE APPROACHES AN D EMOTIONAL/BEHAVIORAL SYMPTOMS IN YOUTH by KURT EINHOLZ B.A., University of Colorado Boulder, 2013 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Doctor of Psychology School Psychology P rogram 2018
ii 2018 KURT EINHOLZ ALL RIGHTS RESERVE D
iii This thesis for the Doctor of Psychology degree by Kurt Einholz has been approved for the School Psychology Program by Franci Crepeau Hobson, Chair, Advisor Bryn Harris Colette Hohnbaum Date: Ma y 12, 2018
iv Einholz Kurt (Psy.D., School Psychology) Parental Discipline Approaches and Emotional/Behavioral Symptoms in Youth Thesis directed by Associate Professor Franci Crepeau Hobson ABSTRACT This study aimed to explore methods of discipline parents use with their children and to determine if specific methods of discipline are associated with emotional/behavioral symptom severities as measured by the Behavioral Assessment of Children, Third Edition (BASC 3). Other factors included in the study were demographic information such as age of child, parent marital status, and ethnicity. Participants were 119 children and adolescents ranging in age from 3 to 18 years who had received services from a privat e clinical practice Data w ere gathered from psychological evaluations conducted at the private practice. Results indicate that taking away privileges for misbehavior was the most common form of discipline used by parents of participants, followed by the use of timeouts. Significant differences in the use of disciplinary practices were observed by child age group. The use of timeouts as a disciplinary strategy was significantly associated with higher BASC 3 Ag g ression scale scores. Marital status was also significantly related to BASC 3 Depression scores with children of separated/divorced parents scoring significantly lower than children of married parents. Study findings suggest that discipline practices can have an impact on child mental health. Implicat ions of these findings are discussed. K eywords: discipline, emotional/behavioral symptoms The form and content of this abstract are approved. I recommend its publication. Approved: Franci Crepeau Hobson
v T ABLE OF CON TENTS CHAPTER ABSTRACT ................................ ................................ ................................ ................................ ................................ ............................... iv INTRODUCTION ................................ ................................ ................................ ................................ ................................ ...................... 1 REVIEW OF THE LITERATURE ................................ ................................ ................................ ................................ ............................ 2 METHODOLOGY ................................ ................................ ................................ ................................ ................................ ..................... 6 RESULTS ................................ ................................ ................................ ................................ ................................ ................................ ... 8 DISCUSSION ................................ ................................ ................................ ................................ ................................ ........................... 10 REFERENCES ................................ ................................ ................................ ................................ ................................ ......................... 13
1 CHAPTER I INTRODUCTION The term mental illness refers to diagnosable disorders of the mind with symptoms including sustained abnormal thought patterns, moods, and behaviors that cause distress and impair daily functioning (American Psychiatric Association, 2013) Individuals with mental illness may experience difficulty with relations, social interactions, and occupational demands and in some cases may lead to premature death. The Center s for Disease Control reports that approximately 25% of all American adults h ave mental illness and that 50% of American adults will develop a mental illness within their lifetime ( Reeves et al., 2011) Additional surveys of American adults indicated that roughly a third of the U S population ha s suffered from mental health diffic ulties within the year prior to complet ion of the survey (Kessler, Chiu, Demler, & Walters 2005), and that approximately half of all adults respondents with mental health difficulties recall mental health concerns arising within their teenage years (Kessl er, Berglund, Demler, Jin, Merikangas, & Walters 2005). Recent findings from national surveys of American adolescents indicate that roughly one in every four to five meets criteria for a mental disorder with severe impairment across their lifetime, and th at a large proportion of mental illness in American adults likely develop during their youth ( Merikangas et al., 2010). Such high prevalence rates of mental illness in adolescents, especially with risk of maintaining the illness throughout their lives, presents serious concern s in terms of being. To help prevent and treat mental illness in adolescents, the factors that influence the development of mental health issues in youth need to be ascertained One factor of focus for this study is parental discipline practice, as previous studies suggest increased risk for development of emotional and behavioral problems when children are exposed to specific consequences for behaviors ( Flouri & Midouhas, 2017 ; Gerschoff et al., 2010) This study aims to expand on previous studies examining disciplinary approaches corresponding to operationalized categories Specifically, the present study is guided by the following research questions: What methods of discipline are parents using with their children ? Which disciplinary practices are being used more or less frequently across child age groups ? What is the relationship between symptom severities as measured by the Behavioral Assessment of Children, Third Edition (BASC 3), paren tal discipline practices, and demographics including child age, gender, parent age, parent marital status, parent education level, and ethnicity/background ?
2 CHAPTER II REVIEW OF THE LITERATURE Trends and Development of Problematic Behaviors, Emotional Symptoms, and Developmental Disorders T behaviors on the Child Behavior Checklist (CBCL; Achenbach, 1991) obtained at five time points with 2 year intervals from over 2000 boys and girls age s 4 through 18 over a ten year timespan. The authors defined Internalizing problems to include anxiety, d epression, somatic complaints, and withdrawn behavior; while Externalizing problems include s aggressive behavior (teasing, fighting) ; delinquent behavior (lying and cheating); attention problems; and other problems that included social difficulty and thoug ht problems associated with psychotic features. S tudy findings indicated that boys and girls demonstrate d equal levels of Internalizing problems in early childhood though girls generally develop ed greater Internalizing problems than boys with increased age. More specifically, statistically larger increases for s omatic complaints were observed for girls than for boys over time, and anxious/depressive symptoms for girls rose initially then decreased following a peak. Anxious/depressive symptoms remained level for boys over time and withdrawal behaviors increase d at equal rates between boys and girls, Externalizing problems were consistently higher in boys than girls throughout all ages Interestingly, decreased aggressive problems for both boys and girls occurred with age, while delinquent behavior increased for both boys and girls with age. Attention problems increased for both boys and girls up until the age of 11, then decreased. Although this stud y provides some insight into how challenging behaviors develop in children, the study was limited by the sole use of parent reports of child behavior. The lifetime prevalence of mental health disorders for U S adolescents was explored in a 2010 study by M erikangas et al. The research team surveyed over 10,000 adolescents ranging in age from 13 to 18 to gather data on the presence of DSM IV disorders. One major finding of the study indicated that adolescents experience high rates of mental health disorders, with approximately 50% of adolescents experiencing at least one class of mental health disorder. Twenty percent of the full sample displayed more than one class of disorders and 27% experienced severe impairment. Anxiety, mood, behavior, and substance use disorders were most prevalent with estimates that anxiety disorders affect nearly 1 in 3 adolescents (Merikangas et al., 2010) The research also examine d prevalence rates across ages in adolescence and alludes to continuously higher rates of mental heal th disorder prevalence with each year of increased age. Certain disorders such as anxiety remain relatively stable across age, but rates of mood, behavior, and substance abuse disorders rise with increased age. The study provides a comprehensive investigat ion into the current states of mental health in adolescents, and
3 findings suggest that the majority of mental health disorders develop before adulthood (Merikangas et al., 2010) High prevalence rates of mental health disorders in adolescents demonstrate a serious public health concern and necessitate further understanding of risk factors and predictors that influence adolescent and child onset of mental health disorders. Behavio ral Inhibition and Emotional/Behavioral Symptoms Behavioral inhibition is defined as the extent to which a child displays inhibited responses (fear and withdrawal) to novel situations or stimuli (Kagan, Reznick, Clarke, Snidman, & Garcia Coll, 1984). Past research has examined behavioral inhibition a s a predictor of future behavior/mental health Several studies have found associations between greater behavioral inhibition in young children and greater likelihood of development of social anxiety issues and decreased disruptive behaviors (Reznick, Hegeman, Kaufman, Woods, & Jacobs, 1992; Biederman et al., 1993; Biederman et al., 2001). As behavioral inhibition became an area of greater focus, questions arose around how parent ing might impact behavioral inhi bition. Infant emotionality, parental sensitivity, and inhibition were explored in a 1997 study performed by Park, Belsky, Pu tnam, and Crnic. The authors gathered data from 125 married families and their infant firstborn sons. Parents completed the Infant Behavior Questionnaire (Rothbart, 1986), to assesses for observable behaviors of their infants in differing situations. The children w ere then brought to the laboratory at the ages of 12 to 13 months and exposed to experimental probes designed to evoke inf ant positive and negative emotion including the standard Strange Situation (Ainsworth, Blehar, Walters, & Wall, 1978) reactions and behaviors were recorded and coded for analysis Naturalistic observations of parenting practices were condu cted at intervals over an 18 month span to gather ratings of parenting positive affect, negative affect, sensitivity, intrusiveness, and attachment. The children were then brought back into the laboratory between the ages of 36 and 37 months and exposed to a series of events that yielde d Inhibition ratings. Findi ngs of the Park e t al. study (1997) indicate that infants exposed to higher amounts of negativity at early age s are more likely to be more inhibited, but that exposure to positivity acts as a protective factor against negativity and reduces futur e inhibiti on. The study also illustrate s behavior replicating earlier study findings ( e.g., Arcus et al., 1992). The effects of positivity, negativity, an d sensitivity of parents shed light on how certain components of parenting during child ren may influence behavioral inhibition. A recent longitudinal study examined behavioral inhibition, parenting style, and behavioral probl ems ( Williams et al. 2009 ) The study authors aimed to determine if levels of behavioral inhibition and parenting approaches impacted the development of internalizing and externalizing behaviors throughout childhood and adolescence. Data for the study was acquired from 113 fami lies
4 over a 14 year timespan. The children were assessed for behavioral inhibition at the ages of 14 and 24 months using novel situations generated in a laboratory setting. Mothers of the children completed self reports of their parenting style when their child was 7 years of age through administr ation of the Parenting Practices Questionnaire (Robinson et al. 2001). Parents also completed the Child internalizing and externalizing behavior problems displayed (Williams et al., 2009). Study results indicated that internalizing behavior problems increase d as the children aged and externalizing problems decreased past the age of 4. Another finding of the study was that children with e levated levels of behavioral inhibition as infants and toddlers exhibited greater levels of internalizing problems at age 4 with this trend continuing throughout childhood and adolescence regardless of parenting style S imultaneously these children with greater behavioral inhibition levels exhibited decreased externalizing problems to a greater extent during childhood and into adolescence. Different parenting styles were found to have effects on behavioral problems in early childhood (age 4) Specifically children with permissive parent s displayed greater internalizing problems and those with authoritarian parent s displayed greater externalizing problems (Williams et al., 2009) Taking behavioral inhibition, parenting style, and behavioral problems all i nto account the Williams et al. 2009 study found that at age 4 internalizing problems were greatest among behaviorally inhibited children with permissive parenting style mothers, while children with higher authoritative parenting style parents displayed less of an increase in internalizing behaviors throughout their childhoods and adolescence Finally, children with higher authoritarian parenting style parents were shown to have a steeper decline in their externalizing problems over time. A lthough the stu dy was limited by the relatively small sample size the study provides insight into the relationships between parenting style, behavioral inhibition, and development of behavioral/emotion al difficulties. In addition, the research also provides evidence of parenting approach es potentially exacerbating or minimizing the impacts of behavioral inhibition on maladaptive behavior development. Parental Discipline and Emotional/Behavioral Symptoms Since methods of discipline have been shown to effectively yield similar results in compliance (Larzelere & Kuhn, 2007), researchers have explored whether there were unforeseen emotional/behavioral benefits or consequences to utilizing certain disciplinary methods over others. A study performed by Gerschoff et al. ( 201 0 ) evaluated parent discipline practices and associations perceived normativeness of discipline tactics utilized. The authors ga thered data from 292 families from six international countries. Researchers interviewed mothers about their discipline strategies for child misbehavior or obedience and had them complete a
5 questionnaire asking about the frequency of engaging in a range of discipline practices These practices included : teaching about good and bad behavior, getting child to apologize, giving child a time out or send them to their room, taking away privileges, using corporal punishment, expressing disappointment in their acti ons and or explaining how their actions made them feel, shaming, yelling or scolding, withdrawing love for misbehavior, threatening punishment, and promising a treat or privilege for good behavior. Parents and children were then asked about their perceived normativeness or their perceptions of commonality of the discipline method and frequency of the above mentioned discipline practices. Parents then completed the Child Behavior Checklist (CBCL; Achenbach, 1991) to provide data regarding child a ggression and symptoms of a nxiety and d epressi on Results of the Gerschoff et al. study indicate that the frequency of discipline had no effect on behavioral problems and that no disciplinary method was associated with l ower levels of aggression or anxiety. There w ere however findings that suggest that the discipline methods of corporal punishment, expressing disappointment, and yelling or scolding were each associated with incre ased child aggression, and that giving a time out, using corporal punishment, expressi ng disappointment, and shaming were associated with a moderating effect on some punishments (corporal punishment and yelling) to mi tigate behavioral problems, but only to a slight degree (Gerschoff et al., 2010) Based in the United Kingdom, Flouri and Midouhas (2017) conducted a study examining the impact of harsh parental discipline (HPD) and socio economic status (SES) on children gathered for over 16,000 United Kingdom children at the ages of 3 5, and 7 years using the parent report Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). HPD was measured using parent report on the Conflict Tactics Scale (Straus & Hamby, 1997). Results from analysis indicated that the usage of HPD by parents increased risks of children to develop greater internalizing and externalizing behaviors. The team also compared HPD practice to SES and found that lower SES parents were not more likely to employ HPD ( Flouri & Midouhas, 2017 The study findings pr ovide further evidence that specific parenting disciplinary approaches may influence the development of behavioral and mental health challenges n children, and that further research into parental discipline across various demographics is warranted.
6 CHAPT ER III METHOD OLOGY Participants Study participants were identified via record review at a private clinic located in a large city in the western United States Records for clients evaluated from 2016 to 2017 were reviewed. Psychological evaluations for children and adolescents ranging in age from 3 to 18 years of age were analyzed for the purposes of this study. Inclusion criteria included: parent(s)/caretaker( s) of the examinee completed the Behavior Assess ment System for Children, Third Edition ( BASC 3 ; Reynolds & Kamphaus, 2015) Parent Ratings Scales form, parent(s)/caretaker(s) of the examinee responded to the intake packet question regarding discipline practices, parent (s)/caretaker(s) of the examinee re sponded to the intake packet demographic questions, and the examinee did not qualify for an Intellectual Disability. Measures Upon intake and prior to evaluation, parents completed a Client Registration Form and client background information packet to prov ital status, parent education level, diagnoses and other conditions, and a question inquiring about disciplinary approaches and con sequences for misbehavior. Parents also completed t he Behavior Assessment System for Children, Third Edition (BASC 3) (Reynolds & Kamphaus, 2015). The BASC 3 is a multidimensional and multimethod evaluation of child and adolescent behaviors and symptomat ology. The BASC 3 consists of five separate assessments : parent rating scale (PRS), teacher rating scales (TRS), self report of personality (SRP), developmental history, and classroom observation ; any of which can be used in isolation or in combination with one another. Clinical and adaptive behaviors are quantified on the BASC 3 and operational definitions of behaviors are provided to assist with DSM 5 (American Psychiatric Association, 2013) diagnosis and educational disability determination. The BASC 3 has both strong internal consistency and high test retest reliability and can typically be administered and scored within 30 minutes ( Reynolds & Kamphaus, 2015). T he BASC 3 also has validity scales for monitoring truthfulness and consistency to the respon The component of the BASC 3 to be utilized in this study is the Parent Rating Scales (PRS) forms. Forms are available for different age ranges and rate behaviors on the following scales: Aggression, Hyperactivity, Conduct Problems, Anxiety Depression, Somatization, Attention Problems, Atypicality, Withdrawal, Adaptability, Leadership, and Social Skills. Responses of behavior s are rated on a 4 point scale from Never (1) to Almost always (4). The scales are compiled into the larger composite s of Internalizing
7 Problems, (Anxiety, Depression, Somatization), Externalizing Problems (Hyperactivity, Aggression, Conduct Problems), School Problems (Attention Problems, Learning Problems), and Adaptive Skills (Adaptability, Social Skills, Leadership). Scales that measure Aggression, Hyperactivity, Anxiety, Depression, and Atypicality form the Behavioral Symptoms Index (BSI). T scores are provided for each scale and composite, with higher scores indicating a greater presence of emotional symptoms or diff iculty. If more than one parent form was completed, all forms were included in the data analysis. Procedure Participant identification was initiated with a review of evaluations in client files For data collection, files were reviewed in alphabetical order to determine if inclusion criteria w ere met If the record met inclusion criteria, BASC 3 results (individual clinical scale and composite t scores) and demographic information were compiled. Demographic data gathered included child a ge (both numerical and child age category groupings of 3 7 years of age, 8 12 years of age, and 13 17 years of age to reflect developmental stages with equal age ranges); child gender (male/female), male parent age (numeric), female parent age (numeric), p arent marital status (married/separated divorced/widowed/single), and ethnicity (white/black/ L atino/ A sian/mixed race). Responses to the question about disciplinary approaches and consequences for misbehavior were coded into one or more of the following gro ups used in earlier studies: teaching about good and bad behavior, getting child to apologize, giving child a time out or send them to their room, taking away privileges, using corporal punishment, expressing disappointment in their actions and or explaini ng how their actions made them feel, shaming, yelling or scolding, withdrawing love for misbehavior, threatening punishment, and promising a treat or privilege for good behavior. Analysis Data w ere analyzed using descriptive statistics chi square tests of association, and a multivariate analysis of variance test. Specifically, t Are disciplinary practices associated with child age conducted. What is the relationship between symptom severities as measured by BASC 3 t scores, parental discipline practices, and demographics?
8 CHAPTER IV RESULTS A total of 119 participant records met inclusion criteria for the study. Study participants ranged in age from 3 to 17 with more ma l es (71.7%) than females (28.3 %) Just under 30% of participants were in the 3 7 age group ; 52.1 % were in the 8 12 age group, and 18.5 % were 13 17 years of age The majority of participants ( 82.4 %) were Caucasian The next largest ethnic group was two or more races (10.1%) The rest of the participants were Latino Black/African American or Asian/Pacific Islander. Most of the parents were married (82.8%) while 13.8 % of parents were divorced A small percentage of parents were widowed (0.9%) and 1.7 % of parents were single. What methods of discipline are parents using with their children ? frequency data was compi led and are presented belo w in T able 1. Discipline method categories included teaching about good and bad behavior, getting child to apologize, giving child a time out or send them to their room, taking away privileges, using corporal punishment, expressing disappointment in their actions and / or explaining how their actions made them feel, shaming, yelling or scolding, withdrawing love for misbehavior, threatening punishment, and promising a treat or privilege for good behavior. Table 1 Frequen cy of Discipline Method Use Discipline Method N( Percent ) of Parents Indicating Use Loss of Privileges Timeout Teaching Good and Bad Behavior 80 ( 67.2 ) 70 ( 58.8 ) 26 ( 21.8 ) Promise Treat for Good Behavior Corporal Punishment Getting Child to Apologize 17 ( 14.3 ) 12 ( 10.1 ) 9 ( 7.6 ) Shame/Yell/Scold 9 ( 7.6 ) Withdraw Love Express Disappointment 1 ( 0 .8) 0 Threaten Punishment 0 Results indicate that the most popular form of discipline approach utilized by parents in this sample is taking away privileges for misbehavior, followed by t imeouts and teaching about good and bad behavior One participant identified using withdrawing of love for misbehavior, and no participants identified threatening punishment or expressing disappointm ent as their disciplinary approach. Are disciplinary practices associated with child age ? a series of chi square test s w ere conducted. Discipline method categories included teaching about good and bad behavior, getting child to apologize, giving chi ld a
9 time out or send them to their room, taking away privileges, using corporal punishment, expressing disappointment in their ac tions and or explaining how their actions made them feel, shaming, yelling, or scolding, withdrawing love for misbehavior, threatening punishment, and promising a treat or privilege for good behavior. Child age categories included 3 to 7 years of age, 8 to 12 years of age, and 13 to 17 years of age Analyses indicate some violations of assumptions and thus, results should be interpreted with some caution. Significant associations were found between the discipline method getting child to apologize and child age group 2 (2, N = 1 19 ) = 7 8 0, p =. 02 2 2 (2, N = 119) = 15.54, p <.001. Getting children to apologize in the age group 3 7 was utilized more frequently than expected and getting children to apologize in the age group 8 12 was utilized less often than expected. Corporal punishment in the age group 3 7 was utilized more likely than expected, and c orporal punishment in the age group 1 3 1 7 was utilized less than expected Shame/yell/scolding in the age group 8 12 was utilized less often than expected, and shame/yell/scolding in the age group 13 17 was utilized more frequently than expected. What is the rela tionship between symptom severities as measured by BASC 3 t scores, parental discipline practices, and demographics including gender, parent marital status, and ethnicity/background ? a multivariate factorial analysis of variance test was conducted. Assu mptions were checked and met Results indicate a statistically significant difference in BASC 3 t scores based use of timeouts, F ( 14, 60) = 2.995 2 = .41 Specifically, A g gression scores were significantly higher in children whose parent (s) endorsed use of timeouts ( F [ 1, 22 ] = 7.156; p < .01; partial 2 = 089) P was also found to be significantly related to BASC 3 Depression scores F ( 1, 22 ) = 8.343 p < .0 1 ; 2 = 103. Results indicate that children of divorced or separated parents had significantly lower Depression t scores on the BASC 3 than did children of married parents No other significant differences in BASC 3 scores were observed based on demographics.
10 CHAPTER V DISCUSSION The purpose of this study was to determine if parental discipline practices for child mis behavior were associated with emotional/behavioral symptoms in children, as well to determine which methods of discipline were more commonly utilized by parents across child age groups. Participants were 119 children ages 3 17 receiving assessment or therapeutic services from a private psychological clinic in a large city in the western U.S. Data were collected via a record review. The results indicate that for this sample, there are two overwhelmingly preferred or commonly used practices of parental discipline approach: t aking away privileges for bad behavior and giving timeouts/sending child to their room. Other forms of discipline approaches such as teaching about good and bad behavior, promising a treat for good behavior, corporal punishment, getting child to apologize, shame/yell/scold, and withdrawing love are utilized, but to a much lesser degree. These finding s differ from previous resea rch where the different discipline approaches were more evenly reported as being utilized (Gerschoff et al., 2010). However th e Gerschoff et al research was with a small sample of international families which might help to explain the differing results. A meta analysis performed by Larzelere and Kuhn (2007) on the efficacy of parenting disciplines concluded that conditional spanking, timeouts, and verbal reasoning combined with nonphysical punishment were equally effective in reducing behavioral problems The Larzelere and Kuhn study also found that e ffective parents pick and match appropriate disciplinary methods to different situations rather than relying one specific method for all misbehavior. Th e present n (58.8%) of parents utilize the effective method of timeouts but that other identified effective methods such as teaching abou t good/bad behavior may be less common in daily parenting disciplinary practice. Additionally, the study sample illustrates the d ependence on one or two primary methods of discipline rather than the usage of multiple methods of disciplinary practi ces. Study r esults indicate significant differences in the use of discipline practices based on the age of the child For younger children (3 7 years of age) the methods of corporal punishment and getting child to apologize were more likely to be used ; f or older children (8 12 years of age), the methods of getting child to apologize and shame/yell/scolding were less likely to be use d while these same practices were more likely to be used with adolescents (13 17 years of age) C orporal punishment was less likely to be used with adolescents. These results mirror earlier study findings indicating a downward trend in the use of physical discipline as children age ( Zolotor, Theodore, Runyan, Chang, & Laskey, 2011). Findings from this study indicate that there is a significant relationship between the usa ge of timeouts/sending a child to their room on symptom severit y as measured by the B ASC 3. Aggression t scores for children whose parents reported using timeouts as a disciplinary approach were statistically significantly higher, meaning these children were more likely to act in a hostile manner (either
11 verbal or physical) that is threatening to others As detailed earlier in this study, timeouts/sending a child to their room is one of the most widely used forms of parental discipline and it appears that it may be tied with unintended consequences on child behavior. Although removing children with aggressive tendencies from others may be utilized because results in a safer environment for other s this disciplinary practice does not allow for teaching of alternative or more adaptive behaviors. Interestingly and contrary to previous research (e.g., Gerschoff et al., 2010) the use of timeout was the only disciplinary practice significantly associated with aggression and no disciplinary practice was related to any other BA SC 3 clinical scale score. Gerschoff and his team found that the discipline methods of corporal punishment, expressing disappointment, and yelling or scolding were each associated with increased child aggression, and that giving a time out, using corporal punishment, expressing disappointment, and shaming were associated with increased child anxiety ; none of which were identified as having significant effects in th e current study. Th e present also differ from other research indicating that children exposed to harsh discipline practices (smacking, shouting at, and telling off) demonstrated increased internalizing and externalizing behaviors (e.g., Flouri & Midouhas 2017) Findings from this study also indicate that there are significant effe cts of marital status on symptom severit y Children with divorced/separated parents had significantly statistically lower t scores on the BASC 3 Depression scale than children with married parents. These findings contradict previous studies (e.g., Strohschein 2005 ; Hoyt, Cowen, Pedro Carroll, & Alpert Gillis 1990 ) that suggest parental divorce increases depressive and anxious symptoms in children. Previous s tudies also found that children of legally divorced parents exhibit less symptoms of depression than children of emotionally divorced parents (e.g., Hashemi & Homayuni 2017 ), and that children with married parents who later divorce show greater symptoms of depression than children whose parents remain married (e.g., Strohschein 2005) No information was acquired in this study pertaining to marital satisfaction or future marital status post assessment These contradicting results indicate a need to better examine factors wit hin marital status and their potential impact on child emotional/behavioral symptoms. Limitations A l imitation of this study is having a small sample size consisting of children receiving services from a psychological clinic, making results difficult to generalize to the general population Small sample sizes decrease statistical power Further, children receiving evaluation services are not representative of the general population since pre existing parental concern led to seeking out evaluation services. In addition, all data were obtained via self report information from parents and data related to disciplinary practices could not be verified for accuracy Self report information may not be truly representative of actual approaches, as parents may omit reporting less socially acceptable practices despite potentially endorsing such approaches in given scenarios ( Van de Mortel, 2008; Bornstein et al., 2015). Other limitations of this study include a lack of diversity in the sample (primarily Caucasian), unequal male and female group sizes (primarily male), and violations of assumptions of chi square data analysis. Limited diversity and unequal
12 male/female gro up sizes restrict generalizability as they do not reflect population diversity and gender distribution, and chi square assumption violations reduce results confidence. Conclusions and Future Directions There is still much to be learned about how parents and parenting discipline approaches may impact the health and wellbeing of children. In addition to identifying common parent disciplinary practices and associations between child age and disciplinary pra ctices utilized, it study findings indicated that the popular practice of giving a child a time out/sending them to their room is correlated with increased levels of aggressive behavioral symptoms. The se findings provide support for the use of a more diversified range of disciplinary tactics and as such, parents may want reconsider the use of timeouts as a primary means of discipline. Findings of the present research study also suggest that children of divorced parents have lower levels of depressive s ymptoms than those with married parents creating the need to further explore factors within marital status and their effects on children. Future studies may benefit from larger samples from the general public to increase generalizability of results and the us e of multiple measures such as observation self report educator disciplinary data It would also be helpful to examine the relationship between specific situational discipline approach es to type and severity of child misbehavior, as well as to asses s emotional/behavioral symptoms over a series of years to gather longitudinal data This would aid in determining the impact of discipline on the trajectories o f observed symptoms.
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