3.1. The Role of Gender and Age in the Variables under Study: Multiple Factor Analysis
To assess the effect of gender and age on the variables that were the object of study, we carried out a comparative multivariate analysis of the mean scores for the whole SDQ (emotional and behavioral problems), for the internalizing problems scale, for the externalizing problems scale, and for the score of the psychological control factor of the EES-C based on gender, age (≤12 or ≥13), and the interaction between both variables (Table 1
The multivariate analysis (MANOVA) revealed a major influence of gender (Wilks λ = 0.951, F(3, 754) = 13.049, p < 0.001, ƞ2 = 0.049), age (Wilks Λ = 0.977, F(3, 754) = 5.980, p < 0.001, ƞ2 = 0.023) and the interaction between gender and age (Wilks Λ = 0.984, F(3, 754) = 4.005, p = 0.008, ƞ2 = 0.016).
With regard to the variable of psychological control, univariate comparisons indicate that boys score higher than girls (F(1, 756)= 19.345, p < 0.001, ƞ2 = 0.025). There are no significant differences by age or by the interaction of gender and age. As far as the global score and the scales of the SDQ are concerned, univariate analysis shows that boys score higher on the variable of emotional and behavioral problems (F(1, 756) = 8.132, p = 0.004, ƞ2 = 0.011) and on the variable of externalizing problems (F(1, 756) = 23.24, p < 0.001, ƞ2 = 0.030). Participants aged 12 or younger, in turn, score higher on the variable of emotional and behavioral problems (F(1, 756) = 12.691, p < 0.001, ƞ2 = 0.017), the variable of externalizing problems (F(1, 756) = 4.619, p = 0.032 ƞ2 = 0.006), and the variable of internalizing problems (F(1, 756) = 14.578, p < 0.001, ƞ2 = 0.019). Again, there is no interaction between gender and age.
3.2. Psychological Control and Emotional and Behavioral Problems: Odds Ratio (OR) Association Measure
Our goal was to ascertain the correlation between parental psychological control and mental health by means of OR statistical tools. To do so, the dependent variables utilized here were the global score for the SDQ (emotional and behavioral problems), the score on the scale of internalizing problems, and the score on the scale of externalizing problems. These variables were treated as dichotomous variables, with the dividing line set on the 80th percentile; i.e., P ≥ 80 = Having problems; P < 80 = Not having problems. On a further methodological note, the participants from the clinical and subclinical categories in the original scale [50
] were integrated into the category “Having Emotional and Behavioral Problems, Having Internalizing Problems, and Having Externalizing Problems.” The independent variable in this study was the psychological control factor of the EES-C—once again taken as a dichotomous variable (Normal = 0; High Psychological Control = 1) with the boundary set at the 80th percentile (P < 80 = 0; P ≥ 80 =1).
As can be observed in Table 2
, there is a significant positive correlation between the variable of psychological control and the variables of emotional and behavioral problems, internalizing problems and externalizing problems. More specifically, regarding the variable of emotional and behavioral problems, the odds ratio (OR = 5.986), the limits of the ratios at 95% confidence, and the χ2
test (= 95.099) corroborate the significance of these results (p
< 0.001). Likewise, in relation to the variables of internalizing problems and externalizing problems, both the limits of the ratios and the χ2
test demonstrate how significant the results are (p
Thus, the OR tests suggest that (1) belonging to the group of children whose perceived psychological control is high (through manipulative strategies, such as emotional blackmail or guilt induction) is a risk factor for emotional and behavioral problems with respect to children who report normal or low psychological control, and the likelihood of having mental health problems is 5.986 times greater in the group where perceived psychological control is high than in the group with normal psychological control; (2) the likelihood of having internalizing problems is 3.035 times higher in the group where perceived psychological control is high, and (3) the chance of having externalizing problems is also 4.804 times higher in the high psychological control group.
3.3. Interpreting the Correlations and the Role of Gender and Age: Classification Tree
Lastly, to clarify the interpretation of the correlations outlined above and the role of gender and age in the present study, we performed a classification tree analysis for each dependent variable (emotional and behavioral problems, internalizing problems and externalizing problems) while introducing psychological control and the different gender and age groups as independent variables. In the case of emotional and behavioral problems and internalizing problems, the role of age and gender does not seem to bear any significance among participants who perceive high psychological control. However, the classification tree (Figure 1
) for the variable of externalizing problems shows some correlation with gender among those participants whose perceived psychological control is high.
The accuracy of the classification tree lies at 81.1% (Risk = 0.189; SE = 0.014). We can observe in Figure 1
that the lowest probability of presenting externalizing problems (11.3%) corresponds to participants under 13 years of age who perceive low and average psychological control (Node 4), whereas the highest probability of externalizing problems (62.7%) is to be found among males who perceive high psychological control (Node 6).
Regarding our main research goal, i.e., establishing the correlation between parental psychological control and mental health (emotional and behavioral problems), the results from the OR test indicate that, as a general rule, parental psychological control is a risk factor for both internalizing and externalizing emotional and behavioral problems. In this regard, our research into the connection between these variables has singled out psychological control as one of the leading factors underlying emotional disorders among minors [15
]—both internalizing [18
] and externalizing [60
Research suggests that psychological control correlates more positively with internalizing problems (e.g., [18
]) whereas behavioral control correlates more positively with externalizing problems [60
]. However, in our study, based on subjects who perceive high psychological control, the likelihood of externalizing problems is notably higher than that of internalizing problems. This overlaps to a large degree with results from a clinical sample—utilizing the same tools to measure psychological control (EES-C)—which concludes that adolescents score higher on externalizing symptoms and a higher risk of externalizing symptoms, associated to psychological control [59
]. These similarities may be due to the criteria that were used to identify participants who had emotional and behavioral problems in their teenage years [52
], which would confirm the usefulness of the SDQ scale as a tool for the detection of mental health problems [49
In addition to the above, there is no denying the connection between children’s psychological adjustment and parents’ behavior. Indeed, the effect of the conduct of adolescents on the changes in children’s upbringing has been reported widely [63
]. Externalizing problems are manifested in behaviors, like aggressiveness, hostility, disobedience, and crime [68
]. Some parents strive to control these conducts by resorting to manipulative strategies; e.g., by using emotional blackmail or rejection as a way of disciplining their children [5
Last, regarding the role of gender and age in the connections discussed here, there is only one relevant case. Namely, the classification tree for the variable of externalizing problems shows the significance of gender in the group of participants who perceive high psychological control. More specifically, the participants who are most likely to have externalizing problems (62.7%) are males whose perceived psychological control is high. These results corroborate research indicating that the negative effects of psychological control are more severe in boys than in girls [44
]. It is generally believed that parents still behave more strictly and rigidly with their sons than with their daughters [70
]. Several examples of research done in Spain support the idea that boys perceive their parents with a higher degree of rejection [71
Similarly, boys score higher on the variables of emotional and behavioral problems and externalizing problems. By and large, it can be argued that being a boy is a risk factor for the prevalence of mental health problems, as opposed to being a girl. These results are in line with most research on the subject that, regardless of the version of SDQ utilized (parents, teachers, self-report), confirms that boys score higher on externalizing symptoms, such as conduct problems or hyperactivity [47
Study Limitations and Future Directions
The present study has several limitations, most notably the use of self-reports to assess both mental health problems and psychological control. We believe it would be necessary to rely on other informants in addition to participants themselves. On a related note, within the framework of a bidirectional model for the relationship between parents and children, it may be necessary to assess mental health and psychological control from the point of view of parents. In addition, despite paternal and maternal styles overlapping to a great extent [22
], using one self-report for both parents limits the possibility of establishing and monitoring differences between them, if any do exist.
Furthermore, the ethnic and cultural context of our study population must be considered for further interpretation and generalization of the results presented in this paper. Several studies carried out in Spain and other European countries, as well as in Latin America [18
], suggest that the association between parenting styles and the emergence of clinical conditions varies according to the cultural context. Thus, the influence of culture implies that these results cannot be extrapolated to other countries, especially outside the Western world [81
The conclusions that can be drawn from this study confirm that the likelihood of having emotional and behavioral problems is 5.986 higher for the group with high psychological control, as opposed to that of participants who perceive normal psychological control. In line with this, the group with high perceived psychological control is 3.035 times more likely to have internalizing problems and 4.804 times more likely to have externalizing problems. More specifically, it is the male participants who perceive high psychological control who are the most likely to suffer externalizing problems.
The analysis of mental health risks related to emotional or behavioral disorders in children and adolescents is a key research area worldwide, and it has become a major concern for public health policy-makers. We are, of course, aware of how emotional and behavioral problems in children and adolescents have given rise to much social concern: Not only are they linked to disabilities, suffering, and functional impairment, but they also represent a substantial economic burden for healthcare systems on a global scale. This study makes a significant contribution toward understanding the importance of parents’ psychological control in the emotional and behavioral problems of children and adolescents. The family unit can be a key risk factor (or a protective one) regarding mental health problems. Psychological control is considered a harmful element in parent—child relations: The use of strategies, such as emotional blackmail, guilt induction, love withdrawal, etc., may constitute intrusive behaviors verging on psychological abuse.
Finally, we believe in the value of intervention and training programs for families. Preventive intervention programs for parents can help to develop protective mechanisms for children’s development. A remarkable example is the ACT—Raising Safe Kids Parenting Program, developed by the American Psychological Association, (APA, Washington, EE. UU.), which has been applied in different countries (the USA, Japan, Peru, Colombia, Greece, Bosnia, Turkey, Taiwan, Brazil, and Portugal) with the purpose of developing parenting skills and knowledge through the dissemination of non-violent discipline approaches, anger management techniques, conflict resolution skills, as well as information about child development and the effects of communications media [82
Training parents is part and parcel of children’s upbringing. In addition, this method promotes their development, facilitates the learning of tools for conflict resolution, improves parent—child relations, provides patterns for assertive, effective communication, and heightens the sense of satisfaction and competence among parents when dealing with their parental duties and responsibilities. We also believe in a type of parental training that allows parents to realize that the source of their children’s problems may lie within the parents themselves.
Interventions focused on parents would be of a cognitive behavioral nature, their goals being to improve emotional communication skills (active listening), discipline-oriented communication (establishing clear instructions, boundaries, and rules, as well as behavioral expectations and consequences), discipline and behavior management skills (how to use specific reinforcers and solve problems related to children’s behaviors), and prosocial skills development (teaching parents how to raise their children to share and cooperate). The time allocated to these programs and their intensity should be planned with the aim of producing lasting results, and even though the proposed intervention is interactive and parents are provided with information, facilitators should use skills and training techniques based on observational learning. Among the possible techniques of this sort are, for instance, the presentation of live or virtual models representing the role of parents for helping trainees to learn parenting skills, conduct rehearsals with trainers and with their children, and tasks to be carried out at home.
An important insight parents should acquire is that parental control is necessary during infancy to help children to organize and guide their behavior and regulate their emotions, and then, parental control decreases as the adolescent develops as an autonomous person capable of regulating their emotions. This letting go of control is one of the most important adjustments parents must make to accommodate the new needs of their adolescent children and stimulate their autonomous development [39