Volume 356, 1 July 2024, Pages 715-721Author links open overlay panel, , , , , , , Highlights•

Parenting behavior, including warmth and control, can affect offspring mental health into adulthood.

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We studied parental warmth and control and adult depression among women in rural Pakistan.

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Parental warmth was associated with lower risk of depression in women.

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Parental behavioral control was associated with higher risk of depression in women.

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Parental psychological control was associated with lower risk of depression in women.

AbstractBackground

Parent-child relationship quality can have long-term impacts on child mental health into adulthood. The impact of parental behaviors on the future mental health of children has been understudied in South Asia, where parenting approaches differ from the dominant western approaches often represented in the literature.

Methods

Mothers in rural Pakistan (N = 828) reported on their own mothers' parenting behaviors using the Parental Bonding Instrument (PBI) and were assessed for depression using the Structured Clinical Interview for DSM Disorders (SCID). The PBI includes scales for warmth (care scale) and over-control (protection scale), as well as subscales for behavioral control and psychological control. We used structural equation modeling to test the associations between depression and all PBI scales/subscales.

Results

Increased parental care was associated with lower probability of depression (B = −0.19, SE = 0.09). Parental protection was associated with higher probability of depression (B = 0.25, SE = 0.11). Among the protection subscales, behavioral control was associated with increased risk of depression (B = 0.24, 95 % SE = 0.11) and psychological control was associated with decreased risk of depression (B = −0.28, SE = 0.12).

Limitations

This cross-sectional study used retrospective self-reports of parenting experiences. Participants only reported on their mothers, not fathers or other caregivers.

Conclusions

In a rural Pakistani sample, maternal warmth was protective against adulthood depression. The association between maternal control and depression varied based on the type of control (behavioral or psychological), emphasizing the importance of nuanced measures of parental control in this context.

Section snippetsStudy design and sample

Data were drawn from the Bachpan cohort study, a birth cohort with an embedded cluster randomized controlled trial of a maternal depression intervention (Sikander et al., 2019) Ethical approval for this study was obtained by the Human Development Research Foundation, the University of North Carolina, and Duke University. Participants for this study were recruited during their third trimester of pregnancy and screened for depression using the Patient Health Questionnaire-9 (PHQ-9). Women

Results

Sample characteristics are presented in Table 1. Participants in this sample were about 28 years old on average and had between 0 and 6 children at the 24-month timepoint, with an average of 1.4 children. At 24 months, 16.12 % of participants (n = 133) met criteria for clinical depression according to the SCID. The PBI care scale showed a skewed distribution, with participants reporting relatively high scores (M = 32.9, SD = 4.6, Range = 0–36). The protection (M = 19.7, SD = 5.7, Range = 5–36),

Discussion

The current study examined parental bonding experiences and depression among mothers in rural Pakistan. Results showed that mothers who reported increased maternal care during childhood were less likely to meet criteria for clinical depression at 24 months postpartum. This aligns with previous research showing that the care subscale of the Parental Bonding Instrument is associated with lowered risk for psychopathology among adults (Kidd et al., 2022). This also aligns with the broader parenting

Funding

The Bachpan cohort was established by funding through the Human Development Research Foundation and leveraging the research study funded by the National Institute of Mental Health (U19MH95687) and National Institute of Child Health and Development (R01 HD075875; PI: Maselko).

CRediT authorship contribution statement

Allison Frost: Writing – review & editing, Writing – original draft, Visualization, Formal analysis, Conceptualization. Ashley Hagaman: Writing – review & editing, Conceptualization. Amina Bibi: Writing – review & editing, Project administration, Conceptualization. Sonia Bhalotra: Writing – review & editing, Funding acquisition, Conceptualization. Esther O. Chung: Writing – review & editing, Conceptualization. Sarah C. Haight: Writing – review & editing, Conceptualization. Siham Sikander:

Declaration of competing interest

The authors have no conflicts of interest to report.

Acknowledgements

We would like to thank the team at the Human Development Research Foundation (HDRF) including Rakshanda Liaqat, Tayyiba Abbasi, Maria Sharif, Samina Bilal, Anum Nisar, Amina Bibi, Shaffaq Zufiqar, Ahmed Zaidi, Ikhlaq Ahmad, and Najia Atif. Finally, we are very grateful to the families who participated in the study.

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