PARENTAL BONDS IN CULTURAL CONTEXT:

THE EFFECTS OF PARENT-CHILD BONDS AND CULTURAL VALUES ON

DEPRESSION AND PSYCHOLOGICAL DISTRESS

A Dissertation

Presented to the Faculty of

Pacific Graduate School of Psychology

Palo Alto, California

In Partial Fulfillment of the

Requirements for the Degree of

Doctor of Philosophy in Psychology

by

Susan E. Anvin

June, 2004

PARENTAL BONDS IN CULTURAL CONTEXT:

THE EFFECTS OF PARENT-CHILD BONDS AND CULTURAL VALUES ON

DEPRESSION AND PSYCHOLOGICAL DISTRESS

Susan Anvin

Pacific Graduate School of Psychology, 2004

This study examines the connections between parental bonds, culture and depression. Literature concerning parent-child relationships is examined, starting with the constructs of attachment, and moving to an examination of the research behind Parker, Tupling and Brown's (1979) Parental Bonding Instrument (PBI). Cultural assumptions embedded in these conceptualizations are explored. Common findings with the PBI are then examined, uncovering a strong link between scores on the PBI and several forms of psychopathology, especially depression, found in both adult and child populations. Cross cultural findings with the PBI are then examined. Researchers have found differences in parental bonds in several cultures. However, this research is hampered by several significant confounds, as well as a lack of established validity for the constructs of the PBI in non-western cultures. The importance of measuring cultural values is discussed, and several constructs relating to the measurement of culture are described. Needs for future research are discussed, focusing on accurate prediction of psychological distress and the relationship between culture and parental bonds.

Results from a study with a community sample of 246 Chinese-Americans are reported. Age differences were found on the PBI, in that older participants reported mothers as less Overprotective. All 4 PBI scales were shown to correlate with several measures of depression when general distress was controlled for. PBI scales explained between 2.5 and 5.5 percent of the variance in depression scores. PBI scales were also correlated with cultural beliefs and behaviors. High Independence was associated with viewing both parents as showing less Care. This was particularly true of Independence in the Family domain. Highly independent beliefs about the family were also associated with a view of mothers as more overprotective. Culture moderated the relationship between parenting and depression in a few important ways. First, the relationship between low Care and greater depression occurred only for participants who were more Interdependent. Second, greater discrepancies between beliefs and behaviors served as a buffer between parental Overprotection and depression. Limitations of the study, including use of self-report measures and limits on generalizability, are discussed. Clinical implications, including the need to consider individual differences in culture, and to consider family dynamics in the treatment of depression, are described.

© Copyright 2004

by

Susan Anvin

All Rights Reserved

Parental Bonds in Cultural Context:

The effects of parent-child bonds and cultural values on

depression and psychological distress

This dissertation by Susan Anvin, directed and approved by the candidate’s committee has been accepted and approved by the Faculty of Pacific Graduate School of Psychology in partial fulfillment of the requirements for the degree of

DOCTOR OF PHILOSOPHY

IN PSYCHOLOGY

June 14, 2004

Linda Garcia-Shelton, Ph. D., M.H.S.A.

Vice-President for Academic Affairs

Dissertation Committee:

____________________________________

Julia Shiang, Ed.D., Ph.D.

Chair

Wendy Packman, J.D., Ph.D.

Committee Member

James Livingston, Ph.D.

Committee Member

DEDICATION

To my family,

especially my husband Peter.

We did it!

ACKNOWLEDGEMENTS

No project as large and involving as a dissertation is completed alone. I have had many people helping me along the way and I owe you all a huge debt of gratitude. I could not have done this without you! I'd like to thank the following people for all their help getting me through this process:

Dr. Julia Shiang, my professor, mentor and chair, for providing guidance and support every step of the way through my graduate school career. You saw this project through from my first ideas through to the one that finally worked, and who provided that extra shove of motivation to get me done on time!

Dr. Packman and Dr. Livingston, who served on my committee, and also helped me immensely through the IRB process and in formulating the details of my research

My research group, especially Adrian Maxey, Peng-Chi Wang, Toan Vuong, and Cianni Kwon. Thanks for all the shared hours of data entry and support through the analysis and writing process!

My husband, Peter Anvin, for uncounted hours of motivational support, technical support, participant recruiting, and basically doing everything possible to keep me sane. :) I love you!

My parents, Carol and Nick Esser, for moral support, and many hours on the phone helping me de-stress, and for supporting me throughout my education. Also my sister Valerie for motivation and keeping me laughing.

My friends, both at school and out of it, including but not limited to Rob Millner, Crystal Black, Jeff Uphoff, Kelly Chau, Tamara Dupart, Veronica Cardenas, Keith Burke, John Hawley, Denise Gilbert, and just about everyone who sat in the PGSP computer lab while we were analyzing data. Thanks for listening to me when things were not going well and offering support and suggestions.

To all the folks at www.linuxchix.org, including but not limited to carla, f3ew, akk, dancer, maria, saz, skh, meredydd, helix, aeris, danamania, Daishi, datapard, henna, karynn, peterS, patchworkgirl, plastic, rik, steven, telsa, xTina and so many more for helping me beat Open Office, Access, CUPS and Linux in general into shape and providing support round the clock. You guys rock!

The staff in the PGSP library, for help hunting down references, and especially to Gita for all her assistance with formating and making sense oh the dissertation handbook.

Nora Marquez, Harrianne Mills and all the PGSP staff who helped with clerical, scheduling and paperwork details that helped me make it to defense on time.

Bret Allen, Mrs. Dillon, and all the teachers at St. Monica's school, for all their support and problem-solving to get my packets home to the parents. Although I wasn't able to complete the school-based project, your help meant a great deal to me.

All 246 participants for completing that huge pile of questionnaires. This research would not be possible without your help and your willingness to share a piece of your life with me.

As I look back over the years of work on this project, with all its stops and starts, I know that many more people have helped and nurtured me along the way. I appreciate your being there for me and am sorry if I managed to leave you out of this list. Thank you so much, everyone! I made it through because of you.

TABLE OF CONTENTS

DEDICATION...................................................................................................................	iv

ACKNOWLEDGEMENTS.................................................................................................	v

LIST OF TABLES.............................................................................................................	ix

LIST OF FIGURES.............................................................................................................x

CHAPTERS

I INTRODUCTION.......	1

Attachment theory	1

Cross cultural explorations of attachment	5

Parental Bonding and the PBI: Review of past research	12

Common research findings with the PBI	15

Cross-cultural research with the PBI – Cultural differences	24

Culture and Culture Change	29

Summary and Conclusions	33

Remaining research questions	37

II RESEARCH QUESTIONS.........	39

III METHODS..........	41

Participants	41

Procedures	41

Measures	41

IV RESULTS..........	48

Characteristics of the Sample	48

Question 1: Is there a direct relationship between patterns of parental bonds and depression, or is this relationship better accounted for by general psychological distress?	59

Question 2: Are cultural values as measured by the CBBAP associated with patterns of parental bonds?	63

Question 3: Is there an interaction between parental bonds and cultural values in predicting depression and psychological distress?	65

V DISCUSSION.......	78

Case Examples	83

Main findings: Parental bonds, Distress and Depression	86

Main findings: Parental Bonds and Culture	88

Main findings: The interaction of culture and parental bonds: Care	90

Main findings: The interaction of culture and parental bonds: Overprotection	93

Main findings: Fathers and the dominant influence of Care	94

Unexpected results	96

Limitations and needs for future research	97

Clinical Implications	100

Summary and Conclusions	103

REFERENCES	105

LIST OF TABLES

1.1: Significant PBI predictors of depressive symptoms.................................................	17

1.2: Significant PBI predictors of anxious symptoms......................................................	21

1.3: Summary of Cross-Cultural Differences on the PBI.................................................	26

4.1: Demographic Characteristics of the Sample.............................................................	49

4.2: Socio-economic Characteristics of the Sample.........................................................	50

4.3: Cultural Characteristics of Sample............................................................................	51

4.4: Sample Characteristics: CBBAP scores....................................................................	53

4.5: CBBAP – Demographic comparisons.......................................................................	54

4.6: Sample Characteristics: Parental Bonding................................................................	56

4.7: PBI – Demographic Comparisons.............................................................................	57

4.8: Sample Characteristics: Depression and Distress.....................................................	58

4.9: Depression and distress: Demographic Comparisons...............................................	60

4.10: Mental Health and Occupation................................................................................	60

4.11: Correlations between depression/distress and PBI.................................................	61

4.12: Regression Analyses: PBI, Distress and Depression...............................................	62

4.13: Correlations between CBBAP and PBI...................................................................	64

4.14: CBBAP scores and patterns of parental bonds........................................................	66

4.15: Interactions between Culture and Parental Bonds in predicting Depression: Main Comparisons ..............................................................................................	68

4.16: Interactions between Culture and Parental Bonds in predicting Depression: Domains ..............................................................................................................	69

4.17: Interactions between Culture and Parental Bonds in predicting Depression: Positive Discrepancies ........................................................................................	71

LIST OF FIGURES

4.1: Interaction: Mother Care & CBBAP Independence.................................................	72

4.2: Interaction: Mother Overprotection & Positive Discrepancies.................................	73

4.3: Interaction: Mother Overprotection & Directional Discrepancies............................	74

4.4: Interaction: Father Care & CBBAP Independence...................................................	75

4.5: Interaction: Father Overprotection& Positive Discrepancies...................................	76

4.6: Interaction: Father Care X OP X Positive Discrepancies.........................................	77

CHAPTER I

I INTRODUCTION.......

One of the most powerful forces in shaping human behavior, personality, and values is the process of parenting and a child's relationship with its parents. This relationship begins at birth, and grows through the process of attachment through a child's early years. As the child become older, parents take more of a role as educators, training the child in the skills it will need to interact in society. This process, however, does not occur in a vacuum; it occurs in the context of the larger society, which helps to define both acceptable behaviors for parents and successful outcomes for children. For example, there are laws that govern minimum standards for care and punish parents for gross neglect or abuse. A child's success is also to a large degree measured by its performance in state run schools, and later in establishing a career, family, and social network of their own. It is this cultural context that parents must train their children to interact with, and it is this cultural context that will define the standards by which we judge parents and their relationships with their children. Thus, no examination of parenting is possible outside of the context of the culture parents are embedded in. This relationship between parenting, parent-child relationships, and the larger culture must be held in mind through any examination of parenting in the research literature.

Attachment theory

The process of parenting and of building parent-child relationships begins from infancy and continues throughout the life of the child. The start of this process is described in depth in attachment theory, which has grown out of the pioneering work of John Bowlby and Mary Ainsworth (Bretherton, 1992). Drawing heavily on ethology, Bowlby described a biologically driven system by which an infant strives to maintain proximity to its primary caregiver. Prolonged separation from the caregiver provokes a consistent set of reactions, starting with protesting and crying, and leading to a withdrawal from social interaction. The attachment system serves the evolutionary purpose of protecting the infant from a hostile environment (Main, 1996). The infant will constantly monitor the environment to assess the accessibility of a few older caretaking figures, and when it is aroused or alarmed, will cry for or flee to these individuals for support and protection. Countering this drive to seek protection is the infant's innate drive to explore its environment, and the child will vacillate between periods of exploration and retreats to the protection of the attachment figure (Hazan & Shaver, 1990). Nearly all infants form some degree of attachment to one or more adults by the age of 7 months, and attachments tend to be formed with the individuals who interact most with the infant (Main, 1996). The strength of these bonds is thought to predict the infant's future ability to form social relationships, both with its parents and with other individuals (Bretherton, 1992).

A great deal of early research from Mary Ainsworth went into examining the causes of secure infant attachments (Bretherton, 1992). In a study of mothers in Uganda as well as a sample of mothers in Baltimore, Ainsworth found that infants with a secure attachment to their mothers (i.e. those who were able to leave their mother to explore, and re-unite with her easily to obtain support) had mothers who were more responsive to the infant's communications. This included both the timing and the appropriateness of the mother's response. As the infants grew older, those with sensitive mothers were seen to cry less, and use more benign forms of communication, such as facial expressions, gestures and pre-verbal vocalizations. Although they sought less contact with the mother, the contact appeared more satisfying and affectionate than the contact in less securely attached pairs (Bretherton, 1992). Overall, it is thought that infants of mothers who are appropriately sensitive to their needs develop an internal representation of the world as safe, of others as capable of meeting their needs, and of themselves as worthy of attention (Main, 1996).

Infants are classified using procedures delineated by Mary Ainsworth into one of 3 groups (Main, 1996). Securely attached infants are those who show minor anxiety during brief maternal absences, and are easily soothed at her return. They quickly return to play, stopping to check in with the mother at frequent intervals. Insecure-ambivalently attached infants are those that appear preoccupied with the mother throughout observations. They protest loudly at her departure, and are unable to be soothed and return to play upon her return. They appear clingy and demanding, but do attempt to maintain emotional contact with their mother. Insecure-avoidantly attached infants show little reaction to their mothers at all. They do not cry upon separation, and continue to play by themselves, avoiding contact with the mother when she returns. A fourth group has been added by later researchers, which includes infants with a disorganized attachment style. These infants cannot be classified into any of the original 3 groups, and tend to show a confusing combination of approach and avoidance behaviors toward the mother. This last pattern is seen most often with infants who have been maltreated.

Later research has focused on attachment-like dynamics in adults and their recollections of childhood relationships with their parents, particularly in relation to their own children's attachment styles. Van Ijzendoorn (1995a) conducted a meta-analytic review of studies in which the attachment styles of parents are compared to the attachment styles of their children. He found that parent attachment styles explained 22-35% of the variance in children's attachment styles, showing a strong pattern of intergenerational transmission. Correspondence between adult attachment style and child attachment style was %69-70 across the 3 primary infant classification types, and 63-65% across all 4 infant classification types. Other researchers have shown that adult attachment styles are at least moderately linked with previously measured infant attachment. Waters, Hamilton and Weinfield (2000) describe 3 studies of this type. Two found that attachment security was significantly stable from infancy to adulthood. Discontinuity in attachment security status across all 3 studies was a result of negative life events. In the one study showing no significant stability (Lewis, Feiring and Rosenthal, 2000)., divorce of the parents was significantly related to later attachment insecurity. Van Ijzendoorn (1995b) describes an additional 2 studies of this sort. Both found no stability from infancy to adulthood in attachment classification. Life events such as divorce, parental illness or death in the family explained the discontinuity in attachment status. These factors explained up to 70% of the variance in adolescents' attachment security. Evidence seems to indicate that attachment is likely to be continuous from infancy to adulthood, and that discontinuities tend to be explained by major changes that occur within the context of parent-child relationships.

Attachment theory is at the core of western understanding of parent-child relationships, yet there is some concern about the cross-cultural relevancy of this theory. These relationship patterns may appear to occur in diverse societies and may well initiate from bioevolutionary drives for proximity, but are still nurtured and interpreted through the lens of culture. Western researchers see the child as using the parent as a secure base for independent exploration (e.g. Hazan & Shaver, 1990), a western cultural ideal. Other cultures may see this exploration as less healthy, or may nurture it in a different direction later in life, seeing connection to the family as primary, and forays into the larger world as part of a process of bringing honor to one's family. Each of these would be valid cultural interpretations of the same set of behaviors, and each would lead to a different nurturing of the ever changing bond between children and parents. As parenting diversifies beyond the daily routines of feeding, soothing, cleaning and caring that every infant needs, cultures will begin to diversify in their emphasis on different values for the child. While the seeds of relatedness lie in the early years, the social rules for relating to others will be taught through verbal interactions with the parents, and observing the parents interacting with other adults and children. The parents will carry out, to the best of their abilities, the job of integrating this new person into the larger culture. Attachment is just the first step on this road.

Cross cultural explorations of attachment

Because attachment is presumed to arise out of biological drives, the process of attachment is often assumed to be universal, occurring in all cultures. While researchers tend to agree that infants and young children form bonds with primary caregivers in all cultures, some researchers argue that these bonds do not take the same forms seen in the west, nor do they arise from the same nature of sensitive caregiving on the part of parents. The two non-western cultures that have received the most attention are Japan (Rothbaum, Weisz, Pott, Miyake & Morelli, 2000) and Puerto Rico (Carlson & Harwood, 2003; Harwood, Miller & Irizarry, 1995). In both populations, researchers have found different cultural constructions of parenting, particularly a stronger focus on control of behaviors as opposed to a western encouragement of autonomy. These differences in parenting lead to variations in the parenting behaviors associated with secure attachments, in the way secure and insecure attachment bonds are observed, and in the cultural understanding of optimal or successful child outcomes of early attachment bonds.

Rothbaum et al. (2000) examine attachment in Japan from a largely cultural/theoretical standpoint, referring to only a few key attachment studies. They detail how key attachment concepts, such as sensitive caregiving and secure-base behavior, are fundamentally different in Japanese populations. Regarding sensitive caregiving, they state:

Japanese parents prefer to anticipate their infants' needs by relying on situational cues (Clancy, 1986; Doi, 1973). Sometimes this means identifying situations that may stress their infants and taking anticipatory measures to minimize the stress (Vogel, 1991). Parents in the United States, by comparison, prefer to wait for their infants to communicate their needs before taking steps to meet these needs (Rothbaum et al., 200, p 1096).

They point to findings in US samples in which the Japanese style of sensitive caregiving (anticipating infant needs) has been shown to lead to insecure attachments between mothers and infants, particularly of the ambivalent type. In other words, the same parent behaviors in Japan lead to a securely attached infant, while in the U.S.A. they tend to lead to a child that is unable to be comforted by the mother in times of stress.

Rothbaum and colleagues (2000) also explore differences in infant secure base behavior between the US and Japan. In the US and similar western cultures, attachment researchers tend to discuss secure base behavior in relation to a child's innate drive and tendency to explore the environment while checking in with the primary caregiver for support as needed. However, Japanese babies have been shown to engage in far less exploration than US babies. They are instead, more oriented to their mothers, who will take on an educative stance, communicating with the child and playing together. Rothbaum and colleagues conclude that in Japan, secure base behavior is more related to dependency than independent exploration, and serves to educate the child on socially accepted behaviors rather than establish a sense of personal independence. They encourage researchers to be wary of assuming a connection between security and exploration across cultures, and rather to think of secure base behavior in more global terms, as an infant's sense of safety needed to adapt to the outside world. The type of adaptation needed will vary by culture.

Several researchers responded to Rothbaum et al's 2000 article with critiques ( Chao, 2001; Gjerde, 2001; Kondo-Ikemura, 2001; Posada & Jacobs, 2001; van Ijzendoorn & Sagi, 2001). Overall, the core of these critiques is to indicate that these differences do not mean that attachment theory is not relevant to Japan. Researchers argue that when attachment measurements are modified, similar results are seen in Japan and the USA. For example, van Ijzendoorn & Sagi, and Kondo-Ikemura argue that the strange situation needs to be modified with much shorter intervals of separation from the mother. This is to hold the level of distress of the infants more or less constant with that seen in North American samples. Similarly, Posada and Jacobs, and Kondo-Ikemura argue for cultural adjustments to measures of caregiver sensitivity Kondo-Ikemura go as far as stating that “whether mothers promote infant autonomy or dependency is not relevant (p 825)” to the measurement of maternal sensitivity. In short, these critiques support the notion of cultural differences in the manifestations of attachment while upholding the usefulness of attachment as a theoretical construct that facilitates comparisons across cultures. While this may be true, none of the critiques manage to refute Rothbaum et al's (2000) core assertion – that there are fundamental differences in the behaviors of parents and infants associated with attachment bonds in Japan and the United States.

Harwood and her colleagues approached the comparison of attachment in Puerto Rican and American mothers from a more empirical stance. Harwood, Miller and Irizarry (1995) challenge the notion that attachment is consistent across cultures. Each culture has different demands for families, and attachment bonds are part of the social shaping that trains children to meet these expectations. In particular, the attachment relationship appears to be the mechanism through which children are expected to learn the culturally appropriate balance between autonomy and relatedness. Some societies (USA for example) will aim for a balance that emphasizes autonomy, while other cultures (Asian, Latino) will aim for a balance that emphasizes relatedness. In their book, Culture and Attachment (Harwood, Miller and Irizarry, 1995), they used interview research to capture cultural ideals regarding desirable and undesirable infant attachment behaviors in two groups of middle class and working class mothers: those living in Boston, the locale of the original strange situation studies, and mothers living in urban areas of Puerto Rico. They found that mothers differed in their views of ideal attachment behaviors. American mothers saw self-maximization as a primary goal of child development. This included concepts such as having positive self esteem, and maximizing talents and abilities as an individual. Puerto Rican mothers saw proper demeanor as the most important goal of child development. This included a desire that their child be well mannered, cooperative, and accepted by the larger community.

Harwood et al (1995) also found that mothers differed on what current child behaviors they valued. When describing desirable and undesirable child behaviors in a strange situation vignette, American mothers described as desirable a child displaying a balance between independent playfulness and relatedness. They saw clinginess as the least desirable child behavior. In contrast, Puerto Rican mothers were more likely to describe respectfulness as a desirable behavior, and high activity levels or avoidance of contact with the mother as undesirable behaviors. Although this study included no actual research with children, one could see how these differing ideals would lead to different actions on the part of these mothers. In particular, one notes that the undesirable behaviors reported by the two groups are at opposite ends of a possible spectrum of child behavior. Puerto Rican mothers want children to stay close and dislike avoidance. American mothers want children to be able to be independent as often as they are interactive, and dislike too much closeness or clinginess. Both groups would be sensitive to children's behavior, but would praise or curtail different behaviors. They would encourage different patterns of exploration and proximity to the secure base.

A later study examined how these differences in ideals between American and Puerto Rican mothers play out in actual attachment behaviors (Carlson & Harwood, 2003). Using ratings of videotaped interactions at various points through children's first year of life, they rated dyads for several parenting behaviors, including sensitivity, emotional expression, and physical control. They also observed dyads in the Strange Situation. They found no differences in how many infants were classified as secure. However, American infants were more likely to be classified as insecure/ambivalent, whereas Puerto Rican infants were more likely to be classified as insecure/avoidant. It is interesting to note that these are the exact types of behaviors mothers liked least in the previous study. It is likely that mothers were less able to be sensitive to infants predisposed to show these undesirable behaviors, and thus those infants were less likely to attain a secure attachment bond.

Carlson and Harwood also found cultural differences in the dyadic interactions associated with secure attachments. For American infants, high physical control was associated with insecure/avoidant attachments, whereas high physical control was associated with secure attachment for Puerto Rican infants. Similarly, high sensitivity was associated with insecure/ambivalent attachments for Puerto Rican infants, but with secure attachments for American infants. The authors concluded that attachment researchers should shift to viewing the attachment system less from the child's point of view, and more as a Caregiving Behavioral System, a system viewed from the perspective of the parent. They hypothesize that high sensitivity was inconsistent with the caregiving behavioral system of the Puerto Rican mothers, and that thus it was more likely to create a climate of unpredictable maternal behavior for the infants. This study reveals the behavioral side of the ideals expressed by the mothers interviewed by Harwood et al (1995). In a culture that aims for respectful, proper behavior that enhances ones ability to relate with others, controlling parenting is a predictor of positive child outcomes. In a culture that aims for independence and self-maximization, moderate control and maximal sensitivity are predictors of positive child outcomes.

Overall, the studies described above shows that attachment differs greatly across cultures. Different parenting behaviors lead to successful attachment bonds in different cultures. Similarly, different child behaviors are indicative of successful attachment bonds. The values of a culture modify how a basic, physiological drive for proximity and safety will be carried out. These essential differences in the attachment process will teach children the fundamentals of human relatedness they need to survive in the cultural context they were born into.

Parental Bonding and the PBI: Review of past research

Researchers have long examined how to quantify the bond a child feels with its parents beyond the first few years of its life. These studies extend our understanding of attachment and its affect on a child, by showing how the relationship itself grows and changes over time. It also allows us to study attachment relationships during a period accessible to memory, as most attachment formation happens in a child's pre-verbal stage. Parker, Tupling and Brown in 1979 developed a measure, the Parental Bonding Instrument (PBI), that explores the dyadic relationship between a parent and child through adolescence. Based on past research by several authors, they generated a questionnaire to measure two dimensions of parental bonds – Care and Overprotection. These dimensions can be understood as extensions of the secure base behavior of the infant/toddler. Children continue to seek Care from their parent when they have been overwhelmed in their continuing exploration of the world. However, Overprotection hampers their ability to explore, learn, and develop their own identities.

A discussion of the main features of the PBI will help the reader gain a deeper understanding of the concepts it measures. Both of Parker et al.'s (1979) scales are bipolar, with items that load both negatively and positively. For Care, the positive pole includes items such as “Appeared to understand my problems and worries” and “Could make me feel better when I was upset” (p 10). Negative pole items, labeled as “indifference/rejection items” (p 5) included statements such as “Did not seem to understand what I needed or wanted” and “Seemed emotionally cold to me.” (p 10). For Overprotection, the positive pole included items such as “Tried to control everything I did” and “Was overprotective of me.” (p 10). Negatively loaded items, labeled as “encouragement of autonomy and independence items” (p 5) included “Let me decide things for myself” and “let me do those things I liked doing.” (p 10). Parker et al. also suggest grouping respondents into one of 4 quadrants, based on high and low scores on each of the 2 scales. High Care and low Overprotection was labeled “Optimal bonding” (p 8); high Care and high Overprotection was labeled “Affectionate constraint” (p 8); low Care and high Overprotection was labeled “Affectionless control” (p 8); and low Care and low Overprotection was labeled “Absent or weak bonding.” (p 8).

It is interesting to think about Parker et al.'s (1979) two constructs and four groups in light of the above discussion of attachment, parenting and culture. What is initially obvious is that the judgment inherent in the labeling of these scales. Parker et al. do not refer to their 2nd factor as “Protectiveness” or “Training”, but rather “Overprotection.” Items are also culturally loaded, pulling for self-determined action on the part of the child. The authors do not label the quadrant for high Care and low Overprotection as “Affectionate permissiveness/independence” but rather as “Optimal bonding.” This is clearly tied to western, Individualist notions of optimal development. Good parents train children to think for themselves and allow children to do what they want to do, while offering them the understanding and support they need to develop this free-thinking spirit.

In many ways, PBI scores also express the western ideal for outcomes of the early attachment bond. Securely attached infants, like “optimally bonded” children, independently explore the environment, returning to the caregiver for support and reassurance. Several studies have compared the PBI to other attachment related constructs (e.g. Heiss, Berman & Sperling, 1996; Lopez, 1996; Lopez & Gover, 1993), finding small to moderate correlations between PBI scales and other self-report measures of attachment constructs. Other researchers have applied the PBI as a measure of “adult attachment” (e.g. Judy & Nelson, 2000; Mallinckrodt, Coble & Gantt, 1995; Moller, McCarthy & Fouladi. 2002; TenElshof & Furrow, 2000). This usage is somewhat questionable as these authors made no attempt to validate the PBI against a standard measure of attachment such as the Strange Situation or the Adult Attachment interview. Manassis, Owens, Adam, West and Sheldon-Keller (1999) have conducted the only study to date directly comparing the PBI with the Adult Attachment interview. They found that PBI scores differed between adult attachment groups. Adults classified as “autonomous” (the analog of secure attachment) rated their parents as high in Care and low in Overprotection (i.e., optimal bonding), those classified as “dismissing” (avoidant) rated parents near the mean in Care and low in Overprotection (i.e. between weak and optimal bonding), those classified as “preoccupied” (ambivalent) rated parents near the mean of Care and high in Overprotection ( i.e. between affectionate constraint and affectionless control) and those with unresolved attachment styles (disorganized) rated parents as low in Care and high in Overprotection (i.e. affectionless control). Manassis et al concluded that the PBI scales are clearly related to attachment classifications, but there is no direct mapping between attachment styles and PBI quadrants, and the PBI, unlike the AAI, fails to account for defensive styles such as idealization or anger. Because of this, PBI scores should not be seen as measures of adult attachment per se, but only as a related construct.	Several researchers have modified the PBI to apply it to broader populations, beyond the western, English speaking population it was normed on. It has been translated into Japanese (Sato et al., 1998), Spanish (Gomez-Beneyto, Pedros, Tomas, Aguilar & Leal, 1993), Urdu (language in Pakistan, Mujtaba & Furnham, 2001) and Vietnamese (Herz & Gullone, 1999). It has also bee administered to parents to report on their own behaviors ( Fendrich, Warner & Weissman, 1990; Parker, 1981). This version has been used both for validation of the original measure (Parker 1981) and to gather data on children too young to complete the original self-report measure (Fendrich, et al 1990). Most recently, Stein et al. (2000) developed a child self-report version of the PBI, with simplified language, which can be administered to children as young as 7 years of age. However, the majority of research with the PBI, even with adolescents, has been carried out with Parker et al.'s (1979) original instrument.

Common research findings with the PBI

The majority of research with the PBI has looked for connections between the recollection of parenting and psychological difficulties, especially depression and to a lesser extent, anxiety. Results have been overwhelmingly positive, showing a link between low levels of Care, high levels of Overprotection, and presence or severity of psychological symptoms. Results across several studies are summarized in Table 1.1 for depression and Table 1.2 for anxiety. Overall these results show that in both community and clinical samples (and in both child and adult samples for depression), parental bonds characterized by both low Care and high Overprotection are associated with symptoms of depression and anxiety. Thirty-five studies to date have examined the connection between depression and PBI variables. The majority of these (25) have compared clients with the diagnosis of depression to non-psychiatric controls. Several(10) have also examined sub-clinical levels of depressive symptoms in community samples, looking for correlations between depressive symptoms and PBI scales. Similar results are shown in both groups. Only one study failed to show a connection between PBI scores and depression (Burbach, Kashani & Rosenburg, 1989), presumably because of the small n (12) in their group of depressed children. All others showed at least some connection between Care, Overprotection and depression. In the five studies that report comparative strength of the connection between PBI and depression, Care inevitably emerged as the strongest predictor, either for both parents or for the father alone.

The PBI has also emerged as a significant predictor of depression and related constructs in non-western samples. Sato, Sakado, Uehara, Nishioka and Kasahara (1997) examined PBI score differences between a group of 51 depressed outpatients and 50 matched controls in Japan. They found that patients reported parental bonds that were characterized by low Care and high Overprotection. Sato et al (1998) looked at lifetime history of depression in a group of 418 Japanese adults, 46 of whom had been depressed prior to the study. They found that low Care from both parents was associated with a lifetime history of depression. Finally, Canetti, Bachar, Galili-Weisstub and De-Nour (1997) showed a connection between low Care, high Overprotection and sub-clinical depressive symptoms in a sample of 847 Israeli high school students. Authors have also found connections between the PBI and constructs related to depression, such as

Table 1.1

Significant PBI predictors of depressive symptoms

Study Western samples:	na	Popu-ationb	Mom Care	Mom O-P	Dad Care	Dad O-P
Patton, Coffey,- Posterino, Carlin & Wolfe, 2001	69	clin-C	XXc	X	XXc	X
Carter, Sbrocco, Lewis & Friedman, 2001	55	com-A	X		X	
Shah & Waller, 2000	60	clin-A	X	X	X	X
Stein, Williamson, Birmaher, Brent Kaufman, Dahl et al, 2000	21	clin-C	X	X	X	X
Enns, Cox & Larsen, 2000	138	clin-A	X			X
Duggan, Sham, Minne, Lee & Murray, 1998	34	clin-A	X		X	
Nordahl & Stiles, 1997	41	clin-A	X	X		
Parker, Gladstone, Wilhelm, Mitchell, Hadzi-Pavlovic & Austin, 1997	245	clin-A	X	X	X	X
Kitamura, Sugawara, Sugawara, Toda, et al, 1996	179	com-A	X			X
Rodriguez-Vega, Canas, Bayon & Franco, 1996	60	clin-A	X			
McFarlane, Bellissimo & Norman, 1995	801	com-C	X		X	
Oakley-Browne, Joyce, Wells, Bushnell, et-al, 1995	65	clin-A	X			
Parker, Hadzi-Pavlovic, Greenwald, & Weissman, 1995	176	clin-A	X		X	
Rey, 1995	19	clin-C	X	X	X	
Adam, Keller, West, Larose & Goszer, 1994	16	clin-C	X	X	X	X
Martin & Waite, 1994	681	com-C		X	XXc	
Rodriguez-Vega, Franco, Bayon, Canas, et-al, 1993	30	clin-A	X			
Mackinnon, Henderson & Andrews, 1993	922	com-A	XXc	X	XXc	X
Parker & Hadzi-Pavlovic, 1992	65	clin-A	X		X	
Whisman & Kwon, 1992	150	com-A	X	X	X	X
Hickie, Parker, Wilhelm & Tennant, 1991	69	clin-A	X	X	X	X
Boyce, Hickie & Parker, 1991	149	com-A	X			X
Fendrich, Warner & Weissman, 1990	67	com-C	X	X	X	X
Leon & Leon, 1990	30	clin-A	X	X	X	X
Burbach, Kashani & Rosenburg, 1989	12	clin-C	-	-	-	-
Zemore & Rinholm, 1989	95	com-A		X	X	
Birtchnell, 1988	40	clin-A	X	X		
Plantes, Prusoff, Brennan & Parker, 1988	37	clin-A	X	X	X	X
Parker, Kiloh & Hayward, 1987	26	clin-A	X	X	X	X
Richman & Flaherty, 1987	100	com-A		X	X	X
Parker, 1986	78	com-A	X	X	X	X
Howard, 1981	100	clin-C		X	XXc	
Parker, 1979a -- clinical sample:	50	clin-A	X	X	X	
-- community sample:	242	com-A	XXc	X	XXc	X
Parker, 1979b	289	com-A	X		X	
Total studies (out of 35)			30	22	26	18
Community Adult samples (out of 10)			8	6	8	7
Strongest predictor (5 studies report)			3		5	

a n indicates number of participants in smallest experimental group

b Populations:	com-A: Community adult sample	com-C: Community child/adol. sample

clin-A: Clinical adult sample	clin-C: Clinical child/adol. sample

cXX=significantly stronger relationship w/depression

self-esteem, social support, and well-being in Vietnamese samples ( Dinh, Sarason & Sarason, 1994; Herz & Gullone, 1999) and in Israeli samples (Canetti et al, 1997).	Several studies have also attempted to show if the PBI is more closely associated with subtypes of depression. Parker, Gladstone, Wilhelm, Mitchell, Hadzi-Pavlovic and Austin (1997) showed that depressive patients described by clinicians as having “melancholic” depression reported more Care and less Overprotection (i.e. better relationship with parents) on the PBI than non-melancholic depression (245 total patients). Identical results were found by Parker and Hadzi-Pavlovic (1992) with a sample of 65 melancholic and 84 non-melancholic depressive patients. Melancholic symptoms of depression are considered to be an indicator of endogenous (rather than reactive) depression, as patents with these symptoms are less able to identify a clear precipitant to the episode (American Psychiatric Association, 1994), so these findings may indicate that dysfunctional parental bonds predispose one to reactive depression, but are less related to endogenous depression. This pattern (reactive vs endogenous) was confirmed by Parker, Kiloh and Hayward (1987) in a sample of 26 patients with no known precipitant of depression (endogenous) and 40 who described a probable precipitant to their depression (reactive/neurotic depression). Other studies have compared manic/bipolar depressives with unipolar depressives (Joyce, 1984; Parker, 1979a), and found that patients with bipolar disorders differ from unipolar depressive patients but not from psychiatric controls on the PBI scales. Bipolar disorder is thought to have a strong biological/genetic basis (American Psychiatric Association, 1994), and so these results would support the trend shown above – that PBI scores are most strongly associated with reactive, not endogenous, mood disorders.

Although less thoroughly researched, anxiety has also shown a strong connection to PBI scales (see table 1.2). These studies, like those on depression, have been conducted with both clinical and community populations. Clinical diagnoses examined include Panic Disorder (Faravelli et al, 1991; Silove et al, 1991; Turgeon et al, 2002; Wilborg & Dahl, 1997), Obsessive-Compulsive disorder (Turgeon et al, 2002) and Generalized Anxiety Disorder (Silove et al, 1991). The majority of studies found that all 4 PBI scales were associated with anxiety symptoms or diagnoses (8 studies). Three found that Overprotection from both parents was the only significant predictor (Bennet & Stirling, 1998; Silove et al, 1991; Turgeon et al, 2002) and one found that Care from both parents was the only significant predictor (Carter et al, 2001, African American sample). It appears that there may be a slightly stronger connection between anxiety (particularly panic disorder) and Overprotection than with Care, but more research is needed to clarify this. In particular, research that is sensitive to the different types of anxiety syndromes and symptoms is needed.

The pattern of low Care and high Overprotection has also been associated with other psychological disorders. Schizophrenic patients have been shown to rate both parents as less Caring, and fathers as more Overprotective compared to non-psychiatric controls (Parker, Fairley, Greenwood, Jurd & Silove, 1982). Patients with eating disorders have reported high Overprotection from their fathers and low Care from their mothers in one study (Romans, Gendall, Martin & Mullen, 2001) and mothers as more

Table 1.2

Significant PBI predictors of anxious symptoms

Study	na	Popu-lationb	Mom Care	Mom O-P	Dad Care	Dad O-P
Turgeon, O'Connor, Marchand & Freeston, 2002	38	clin-A		X		X
Carter, Sbrocco, Lewis & Friedman, 2001 Caucasian sample:	55	com-A	X	X	X	X
African American sample:	59	com-A	X		X	
Bennet & Stirling, 1998	30	com-A		X		X
Wilborg & Dahl, 1997	45	clin-A	X	X	X	X
Silove, Parker, Hadzi-Pavlovic,Manicavasagar, et al, 1991 Panic Disorder Generalized Anxiety Disorder	78	clin-A	X	X X	X	X X
Faravelli, Panichi, Pallanti Paterniti, et al, 1991	32	clin-A	X	X	X	X
Leon & Leon, 1990	30	clin-A	X	X	X	X
Zemore & Rinholm,1989	95	com-A	-	-	-	-
Parker, 1986	78	com-A	X	X	X	X
Parker, 1981b	50	clin-A	X	X	X	X
Parker, 1979b	289	com-A	X	X	X	X
Total samples (out of 12)			9	10	9	10

a n indicates number of participants in smallest experimental group

b Populations:	com-A: Community adult sample	com-C: community child/adol. sample

clin-A: Clinical adult sample	clin-C: Clinical child/adol. sample

Overprotective in another (Rhodes & Kroger, 1992). Women with binge eating disorder were more likely than controls to rate parents as showing affectionless control (Fowler & Bulik, 1997). Antisocial and borderline personality disorders have also been linked to low Care and high Overprotection (Norden, Klein, Donaldson, Pepper et al, 1995). Children with conduct disorder or oppositional defiant disorder reported lower Care and higher Overprotection from one or both parents (Rey & Plapp, 1990).

Several studies have attempted to show if the PBI can be better used to predict one diagnosis over another. Most examine anxiety and depression. A pattern of conflicting results has emerged from this research. In a community study of depression, Parker, Hadzi-Pavlovic, Greenwald and Weissman (1995) showed that parental Care was a significant predictor of depression. Their sample consisted of 3684 adults, 176 of which met criteria (based on a clinical interview) for lifetime major depression alone, and 492 of which met criteria for depression and at least one other diagnosis in their lifetime. In their sample, Care also predicted both depression and a lifetime history of any disorder with equal strength. They conclude that the PBI appears to be linked with psychopathology in general, and does not demonstrate specificity for depression. Zemore and Rinholm (1989) report a different pattern of results, exploring sub-clinical levels of depression and anxiety. PBI variables of paternal Care and maternal Overprotection correlated with scores on the Beck Depression Inventory, but not on the Fear Survey Schedule. Authors concluded that parental bonds are specifically related to depression, and not to psychopathology in general. Still another pattern of results was found by Parker (1986) in a study of 39 twin pairs. They found that low Care and high Overprotection was associated with both anxiety and depression symptoms, but that the correlations were stronger with anxiety than with depression. Given this conflicting pattern of results, it is difficult to say what exactly PBI responses can help us predict. It is clear that they show relation to psychopathology in general, but unclear if they provide better predictive validity for any one disorder.

Several patterns can be drawn from the above research on the PBI and mental health. The pattern of low Care and high Overprotection is clearly correlated with psychological symptoms. These symptoms vary greatly, and include psychotic symptoms, mood and anxiety symptoms, and even behavior/impulse control difficulties. Research attempting to find differences in predictive validity for the PBI across different disorders has given inconsistent results, with at least one group of researchers concluding that the PBI is associated with general distress, not any specific form of psychopathology (Parker et al, 1995). However, there also appears to be pattern of differential association with the PBI within classifications of mood disorders, in that reactive disorders show greater correlation with the PBI than endogenous or biologically based conditions. A reasonable conclusion drawn from this body of knowledge would be that parental bonds as measured by the PBI predict how well a person will be able to cope with stressors and avoid distressing psychological symptoms, but are less related to any one grouping of symptoms.

The PBI has been used successfully to examine levels of symptomatology in a variety of research settings. Similar results showing a connection between low Care and high Overprotection and psychological symptoms have been found in both clinical and community samples. Similar patterns of results have also been seen in non western cultures, including Israeli students, Japanese adults, and Vietnamese immigrants to the west. The PBI is clearly an appropriate measure for examining the connections between post-attachment parent-child bonds and mental health across settings and cultures, provided cultural sensitivity is used in the interpretation of results.

Cross-cultural research with the PBI – Cultural differences

As stated above, the PBI is a culturally loaded measure that measures a largely western ideal of parent-child relationships. This measure assumes that more than moderate control will hamper a child's development as an individual(i.e. high Overprotection is associated with negative outcomes), and that what children need most from their parents is nurturance, support and understanding (features of Care). Although the PBI has been applied in diverse cultures, researchers have not paid due attention to the cultural meanings embedded in the constructs of Care and Overprotection. As was seen in studies of attachment discussed above, parents in different cultures have different goals for their children, and will consequently make different choices in parenting their children. Cultural differences on the PBI are to be expected, as it cannot be modified as easily across cultures as the Strange Situation. Thee differences need to be interpreted with caution. Indeed, it is the belief of this author that the PBI scales of Care and Overprotection may not even be relevant outside of the western cultural setting. Most research with the PBI in diverse cultures has been conducted with immigrant groups living in western nations. The PBI offers us an interesting and relevant view of these families, as they are living in and daily interacting with western institutions. These parents will inevitably be judged by schools and communities from a western standpoint. Children will encounter the views of their western peers in schools, and will compare their parents to western parents. Success or failure of these children will also be judged by western standards. Therefore, it is the view of this author that a western measure of “optimal” parent child relationships is relevant to these immigrant populations.

Several researchers have looked at differences between parenting across cultural groups. These studies are sometimes difficult to interpret accurately, because they do not explore individual differences in cultural value within each group. We do not know if there is a relationship between adoption of western values and how parents are viewed by children, and consequently cannot know how much of the differences seen in these studies are caused by cross-generational culture clash. Because of this, results should be interpreted with caution, as they may reflect conflicts caused by the pressures of immigration and acculturation as much as actual cultural differences. A summary of studies examining cross-cultural differences can be found in Table 1.3.

Dinh, Sarason and Sarason (1994) and Herz and Gullone (1999) compared the parental bonds of Vietnamese and Caucasian young adults and adolescents. Both found that Vietnamese participants reported lower Care and higher Overprotection than Caucasian participants. Herz and Gullone also showed some evidence for similar predictive validity of the PBI in both cultural subgroups, in that lower Care and higher Overprotection was linked to lower self-esteem. Ahmad, Waller and Verduyn (1994),Furnham and Husain (1999), and McCourt and Waller (1995) compared Indian and

Table 1.3

Summary of Cross-Cultural Differences on the PBI

Study	Cultural groups	N's	Results Care Overprotection
Dinh, Sarason & Sarason(1994)	Vietnam born US born	49 124	US born > Vietnam born, mother only *	Vietnam born > US born, both parents
Herz & Gullone (1999)	Vietnamese Caucasian (Australian)	118 120	Caucasian > Vietnamese, both parents	Vietnamese > Caucasian, both parents
McCourt & Waller (1995)	Indian girls Caucasian girls	178 158	No differences	Indian > Caucasian, both parents
Ahmad et al. (1994)	Indian girls Caucasian girls	71 115	Caucasian > Indian, mother only	Indian > Caucasian, both parents
Furnham & Husain (1999)	Indian women Caucasian women	55 82	No differences	Indian > Caucasian, both parents
Mujtaba & Furnham (2001)	Women living in Pakistan Pakistani women born in UK Caucasian women	114 118 116	(Women living in Pakistan = Caucasian women in UK) > Pakistani women born in UK, both parents	Pakistani women born in UK > Women living in Pakistan > Caucasian women in UK, both parents
Canetti et al. (1997)	Israeli youth Original norms	847	Israeli youth > Original norms, both parents	Original norms > Israeli youth, both parents
Parker and Lipscombe (1979)	Jewish private school students Non-religious private school students 81 74 Non-religious > Jewish, mother only No differences Greek students (in Aus.) Australian students 125 46 No differences Greek students > Australian students, both parents

* How to read results: “US born > Vietnam born, mother only” means “Participants born in the US reported greater Care than Vietnamese born participants. This was true for mother's Care only”

Caucasian British participants. With one exception, they found that Care was equal between the two groups, but that Indian participants reported more Overprotection than Caucasian participants (Exception: Ahmad et al, found that mother's care was lower in Indian group). All three studies focused on anorexic-like thinking, and showed little predictive validity for the PBI with either group. Mujtaba and Furnham (2001) conducted a similar study with Pakistani and Caucasian participants in the UK, with the addition of a group of subjects from Pakistan. They found that Care was only lower in the immigrant Pakistani group, whereas both Pakistani groups reported more Overprotection than the Caucasian participants, although the immigrant group reported higher Overprotection than the non-immigrant Pakistanis. This indicates that the experience of immigration may change or put strain on parent-child relationships, and that dysfunctional bonds may be overrepresented in recent immigrant groups. Only one study has found less dysfunctional parental bonds in a non-western sample. Canetti, Bachar, Galili-Weisstub and DeNour (1997) compared a group of teens in Israel to the PBI norms reported by Parker (1979) and found that their sample reported more Care and less Overprotection than the original Australian sample. It is interesting to note that this population is one of the only non-immigrant populations examined in this body of knowledge, and it shows the opposite pattern of results. It is quite likely that the experience of immigration, acculturation, and biculturalism had considerable impact on the participants' formation of parental bonds above and beyond the impact of culture alone, as was demonstrated by Mutjaba and Furnham (2001).

Knowing that cultural differences exist in parental bonds as measured by the PBI does not tell us why they differ, or the role the difference serves. It is an interesting question to ponder. Why would Asian and Indian parents, especially those whose parents have immigrated to a western nation, be seen as more overprotective and sometimes less caring? One possibility is that these parents may be trying to pass on their cultural values to their children, in the context of a larger culture that does not share the same values. These parents would face a situation not shared by parents from the dominant culture. They must to some degree shelter their children from the influence of the dominant culture in order to better instill the values of their culture of origin, which may appear to the children as Overprotection. Children might perceive less Care because they might be more acculturated and might have a different perspective on events in the family and in the larger world. This could leave them feeling misunderstood by their parents, or less able to communicate with their parents. These contextual factors would hold true for all families in the process of culture change, even those who have resided in their new home for more than one generation. Furthermore, these Indian and Asian parents are likely to come from a more Collective perspective on child rearing. They may not see independence as an ideal goal for their children. They may well want their children to be able to think and reason, but they will want them to reason about the family's needs and wishes, not about individual needs and wishes. Both cultures also share a cultural constraint on the display of emotions, and thus they show emotional care through physical care, such as food or material possessions. These behaviors would not bee seen as Care on the PBI. These cultural dynamics could understandably cause parents look slightly more Overprotective and less Caring, while serving an adaptive function within the structure of the culture. Children reared in a western setting may experience these differences as conflictual. There are many reasons, explained by the context of an immigrant family as well as by the inherent western/Individualist assumptions in the PBI, that might explain these group differences without concluding that Indian or Asian parents form less optimal bonds with their children. These should be taken into account when drawing conclusions from the cultural differences research discussed above. This analysis also underlines the importance of considering cultural values when exploring cross-cultural differences in relationships.

Culture and Culture Change

Before we can consider the role of culture in parenting and parent-child relationships, we must first understand how culture can be defined and measured. Parenting and parent-child relationships are sensitive topics, and must be examined within the context of cultural values. According to Sprott,

If a society is to perpetuate itself, is does so in part by the way it socializes the young. Therefore, the act of disparaging childrearing preferences of a cultural group strikes at the group's sense of esteem and indirectly challenges their right to exist. (1994, p 1111)

Researchers must be careful to take cultural context into account when studying the behaviors of parents and the relationships between children and parents. Otherwise they run the risk of examining parenting from their own cultural standpoint and wrongly disparaging the styles of parenting chosen in other cultures. Childrearing can be viewed as “the 'medium of the message' of culture, the means to transfer values to the next generation” (Sprott, 1994, p 1111). It is this standpoint we must take to explain differences found in parenting between two groups. We should attempt to understand not just that they differ, but what purposes those differences serve. Then the outcome of parent-child relationships can be viewed more honestly, balancing the costs and potential benefits.

Merriam-Webster Online Dictionary, 10th ed. (2003) defines culture as “ a : the integrated pattern of human knowledge, belief, and behavior that depends upon man's capacity for learning and transmitting knowledge to succeeding generations b : the customary beliefs, social forms, and material traits of a racial, religious, or social group c : the set of shared attitudes, values, goals, and practices that characterizes a company or corporation” Clearly culture is a broad concept, that can describe trends as large as the evolution of society over millennia, and as small as the unique aspects of a sub-group of individuals within a town. Attempts to measure culture need to take this into account. Instruments that aim at measuring culture need to have the ability to describe the several aspects of culture given in the above definitions (beliefs, social forms and material traits; shared attitudes, values, goals and practices) in such a way that differences in each can be compared. They also need to be able to describe these aspects of culture across several domains, which could include family relations, work or school, peer relations, and other social groups. Only this type of diversity of description is likely to show meaningful differences at all the levels culture can be examined, from between continents, to within small subgroups.

In order to be able to compare several cultures on one instrument across many domains, a guiding theory is needed to describe primary dimensions on which cultures commonly differ. The most commonly used distinction in the research literature to date is between Individualist and Collectivist cultures (Trinadis, McCusker & Hui, 1990). Individualistic cultures include many western nations such as the United States, Britain and Australia. Individualist cultures emphasize the uniqueness of the individual, and expect members to make choices based on cost or benefit to that individual. Individuals are expected to be self-reliant and not depend on others for support. Collectivist cultures, on the other hand emphasize the connections between the individual and larger societal groups, often with special emphasis on the family. Members are expected to make choices based on the greater good to their relevant social groups, and the giving and taking of support are encouraged, in their appropriate time and place. People within cultures may vary in their degree of individualism or collectivism, and different cultures may put greater or lesser emphasis on each set of values in different social settings. This conceptualization allows researchers to structure their examination of cultural beliefs, practices and values in various settings. Given that the focus of this distinction is on social relatedness, it is most appropriate for use in research looking at other aspects of social relations.

The majority measures currently available to examine culture fail to live up to the standard described above. Many restrict measurement of cultural identification to basic preferences for language or food rather than looking at an array of beliefs, behaviors and values. Most others sample a broad range of behaviors and ideals, but restrict their results to one or two global scales (Bogumill, 1998). One exception is the Cultural Beliefs and Behavior Adaptation Profile (CBBAP, Shiang & Bogumill, 2001). This measure was generated through a factor analytic study (Bogumill, 1998). Bogumill examined interview data from 117 people of Chinese heritage for descriptions of differences between Chinese and American culture, using Markus Kitayama's (1991, as cited in Bogumill, 1998) theory of Independence and Interdependence as a reference in selecting relevant distinctions. 56 items were generated to tap both beliefs and behaviors across each of 3 domains: family, work and social activities. Factor analysis with a sample of 130 Chinese-Americans and 50 Caucasian-Americans yielded 6 factors: Reciprocity, Family Integrity, Influence of Peers, Value of Peers' and Family's Ideas, Self-Reliance, and Harmony at Work. No further description of the scales were given, but Bogumill notes that the scales did not divide as expected along lines of beliefs vs. behaviors, or based on different domains. Only one scale (Value of Peers' and Family's Ideas) included only belief items, and only 3 scales included items from only one domain (Family Integrity, Influence of Peers, and Harmony at Work).

Using the CBBAP, culture and culture change can be measured. Individuals position regarding Individualism and Collectivism can be compared across groups and within groups. These differences can be captured globally, in specific domains, ore even in the relationship between beliefs and behaviors. The CBBAP is an excellent tool for defining culture, because it allows us to grasp at least some of the complexity inherent in the definition of culture. Using tools such as the CBBAP, we can explore at greater depth the role of culture in shaping parent-child relationships, from early attachments on through the lifespan of an adult.

Summary and Conclusions

The relationship and bond a child builds with its parents shape that child and prepare it to interact with the larger world. This interactive process, which plays out between the parents, the child, and the cultural context, begins from the first moments of the child's life. Through a set of biologically primed actions and reactions, the infant child forms an attachment bond with its primary caretakers. Through caregiving interactions around feeding, soothing and exploring, the child learns to what degree others are available to meet its needs, how best to elicit the attention of important others, and the safe limits on exploration. The child will quickly learn how sensitive its caretakers are to the needs of the child, and the parents will also learn how smoothly the child adapts to changes and disruptions in routine. Although this process is grounded in a set of biological systems, how the process of forming attachments is carried out will depend a great deal on the cultural context (Carlson & Harwood, 2003; Rothbaum et al., 2000).

Different cultures stress different aspects of the attachment relationship. Some cultures will encourage active child exploration, as reflected in the secure base behavior observed by Mary Ainsworth (Bretherton, 1992), where the child leaves the mother to explore, and returns to her only as needed for reassurance. Parents in other cultures might discourage independent exploration, preferring to choose a more educative stance and present to the child opportunities for enrichment. Emotional interactions may also differ between and among cultures. The theory of attachment as developed by Mary Ainsworth puts a great deal of emphasis on the caretaker's ability to quickly interpret and immediately respond to the emotions and signals of the child (Bretherton, 1992). However, cultures may differ in which child signals parents are expected to immediately respond to, and which they are expected to shape. For example, western parents are encouraged to ignore a crying infant at night, and leave it to fall asleep alone in a crib, rather than having parents and infants sleep together. Cultures may also differ on the number of caretakers the child has available (for example, a small nuclear family vs. a large extended family), and the degree and timing of separations the child must learn to negotiate (working mother vs. stay at home mother). These and other outside demands will impinge on the child-caretaker relationship, and help give it a distinct shape that will vary somewhat from culture to culture, as well as withing cultural subgroups. Even a purportedly biological system such as infant attachment is not immune to these influences. As a child grows older and interacts directly with a wider circle of society, the influence of the cultural context on the bond between parent and child grows as well.

The domains of both culture and relationships present measurement challenges, for the very reason that they are complex variables that are difficult to fully capture in isolation from context. In the measurement of culture, researchers have found that they can only truly describe cultures in relative terms – how they are different and how they are alike. This is in part because the researcher cannot function as an objective observer, because they cannot in reality separate themselves from their own cultural worldview. Because of this, the majority of instruments that have been developed explore the dynamics of cultures change (often called acculturation) and are used in research with immigrant or other minority populations. Perhaps the most promising of these instruments is the Cultural Beliefs and Behavior Adaptation Profile (Shiang & Bogumill, 2001), because it gives researchers a multifaceted view of the cultural indentifications of individuals.

Researchers involved in the measurement of parent-child relationships have not spent as much time considering the larger context of these relationships, and consequently the instruments developed tend to reflect the worldview of the researcher and the cultural characteristics of the development sample. One such measure is Parker, Tupling and Brown's (1979) Parental Bonding Instrument (PBI), one of the more commonly used and psychometrically sound measures of parent-child bonds beyond the early years. This instrument was developed through factor analytic studies of several prior instruments, and has been shown to have good reliability, both in terms of internal consistency and test-retest scores over long periods of time. The factor structure, while widely debated, has been shown to be remarkably consistent, with the 2 factor model of Parker et al. (1979) leading to easily interpretable results with more than adequate predictive and construct validity.

The vast majority of the research with the PBI has examined the connections between remembered parental bonds and psychological dysfunction. Researchers have found a connection between both low Care and high Overprotection and a variety of psychological problems, including depression, sub-clinical depressive symptoms, schizophrenic symptoms, anxiety, eating disorders, personality disorders, and disruptive behaviors disorders. What is less clear from this research is if different disorders show different patterns of scores on the PBI. Comparisons across disorders have yielded conflicting results. However, studies within subtypes of mood disorders have shown a pattern of associations between the PBI and reactive disorders only, not those that are judged to be endogenous or predominantly biologically based. For the moment, the research literature on the PBI appears to support only a generic link between parental bonds and the tendency to be distressed by negative life events.

Researchers have also used the PBI to make comparisons across cultures. Although a few gestures towards cross cultural validation of the instrument have been made, these tend to fall woefully short of what is needed. They limit themselves to confirming the factor structure of the PBI in a different culture, or to establishing predictive validity of the PBI in a different culture, and do not address the different meanings these constructs may have in a non-western setting. It is not surprising that researchers have found cultural differences when administering the PBI, a measure of the western ideal of parenting, to members of different cultural groups and subgroups. Parenting and parent child relationships are a primary vehicle for the transmission of cultural values. Therefore if the cultures differ, we should expect that parenting practices and parent-child relationships will differ. Therefore, the fact that researchers have found consistent differences in the levels of Care and Overprotection perceived by Vietnamese and Caucasian children, or between Indian and Caucasian schoolgirls, should come as no surprise. However, we have no knowledge of the cultural views of the samples involved, we only know that the groups came from different cultures. Without knowing anything about how these families are weathering the process of acculturation, we cannot see how much this process is disrupting the usual pattern of the transmission of cultural and social values through parent child relationships. Further research is needed to explore this process more accurately, paying attention to the role of cultural attitudes and cultural change.

Remaining research questions

The research literature on the PBI described above reveals two gaps in our understanding of parent-child bonds. First, it is unclear what causes the connection between PBI scores and so many varieties of psychopathology. It is possible that a negative recollection of ones relationship with parents predisposes a person for psychological distress in general, while other, unrelated factors explain which form this distress will take. It is also possible that some other variable, such as the development of a repertoire of coping skills, the ability to seek and accept social support, or the development of self-efficacy might explain the results. Further research is needed using multivariate statistical techniques to partial out the influence of such variables from the connections between parental bonds and psychopathology.

Second, a closer look at the associations between the PBI and cultural variables needs to be conducted to aid in interpretation of cultural differences in parental bonding. As noted above, it is hardly surprising that non-western parents are rated as less ideal on a western measure of parenting. The literature does not give us enough information to begin to pick apart the meaning of these differences. Two steps need to be taken. Researchers need to examine the construct validity of the PBI in a variety of cultures. This can be done through correlations with cultural beliefs, as well as through new factor analytic studies of parental bonds based on the types of behaviors parents are expected to show in those cultures. Also, the role of cultural beliefs and behaviors in the relationship between parental bonds and mental health needs to be better understood. The studies shown above seem to indicate that PBI scores still correlate somewhat with measures of psychopathology even in non-western cultures. Studies also show that parental bonds are somewhat less ideal in non-western cultures. However, we know that non-western cultures do not have higher incidences of psychological problems (Herz & Gullone, 1999). In order to understand the relationship between parental bonds and mental health across diverse cultures, we need to know how cultural variables interact with this relationship. For example, the PBI taps independent ideals of parenting. Perhaps, the relationship between the PBI and mental health only exists for individuals who have adopted a more western, independent perspective. Alternately, the relationship might be stronger for those who take an interdependent stance, as they will place stronger value on their relationship with their parents. Questions such as these will help us explore the relationship between parental bonds and mental health within the cultural context in which they occur.

CHAPTER II

II RESEARCH QUESTIONS.........

This study addresses two of the main gaps in our understanding of parental bonds. First, it examines specificity vs. generality in the predictions of the PBI, exploring whether PBI scores predict depression above and beyond psychological distress. Second, it examines the relationship between cultural beliefs/behaviors and parental bonds. This relationship is explored alone, and in conjunction with the prediction of depression and psychological distress. The following are the research questions and hypotheses for this study:

Is there a direct relationship between parental bonds and depression, or is this relationship better accounted for by general psychological distress? As discussed above, PBI scores have been shown to be linked to a variety of psychological disorders. This study will use regression analyses to show if the PBI can help predict symptoms of a specific disorder, Major Depression, when general psychological distress is controlled for. Based on past research showing that the PBI is related to a wide variety of disorders, it is expected that the relationship between PBI scores and depressive symptomatology will no longer be significant when general distress is controlled for.

Are cultural values as measured by the CBBAP associated with parental bonds? We know from past research that cultural groups differ in their responses to the PBI. However, we know little about the cultural values underlying these differences. This study will examine correlations between PBI scores and cultural adaptation as measured by the CBBAP. Correlations will be examined between overall cultural identification, between cultural beliefs and behaviors, across the domains of Family, Social and Work, and in relation to any discrepancies between beliefs and behaviors. Past research has not explored this topic, therefore no directional hypotheses have been generated.

Is there an interaction between parental bonds and cultural values in predicting depression and psychological distress? Past studies have shown that responses on the PBI are associated with psychological distress even in non western cultures. However, no studies to date have accounted for the cultural values of the participants. This study will use analysis of variance see whether cultural values moderate the relationship between parental bonds and depression. Cultural values will again be examined in several ways (beliefs vs behaviors, domains, and discrepancies). Past research has not explored this topic, therefore no directional hypotheses have been generated.

CHAPTER III

III METHODS..........

Participants

Research participants were drawn from a larger database maintained by Dr. Julia Shiang and her research group. The database sample consists of 246 Chinese-American adults ages 18-87 (mean = 35.90, SD = 14.65), and is a convenience sample consisting of individuals known to members of the research group. Most reside in the Bay Area of California. Data has been gathered over a period of several years. Further characteristics of the sample are discussed at length in Chapter 4, Results.

Procedures

Prior to data collection, IRB approval was sought and obtained by the researchers who compiled the database. Consent was granted by Dr. Julia Shiang for use of the database in this project. Participants received a packet of questionnaires, consisting of those described below as well as others, and an informed consent form. They were asked to complete the questionnaires and return them with the consent form to the researcher who contacted them about the study. All participants were paid $20 for their participation.

Measures

Demographic Information: Participant age, gender, educational background, SES, ethnicity, daily cultural activities, and family/immigration history.

Parental Bonding Instrument: (Parker et al, 1979) As described above, the PBI consists of 2 scales, Care and Overprotection, which are rated for both the participant's mother and father. The current PBI is a relatively brief and psychometrically sound instrument. Respondents are asked to rate 25 possible behaviors of their mother and father over the first 16 years of their life. The PBI was normed on a relatively large sample of 410 adults and adolescents, aged 12-75 years old (mean 36 years). The sample was selected to be representative of the population in Sydney. Factor analysis of the items revealed 3 factors. However, items on the second and third factor were very similar in content. Those that loaded highly on the second factor tended to have a significant negative loading on the third factor, and vice versa. Parker and colleagues (1979) concluded that a two factor solution would be the most useful for further research. They retained the highest loading 25 items. The resulting scales had high internal consistency (split half reliability of .88) and reasonable test-retest reliability (.76 for Care, .63 for Overprotection). Validity of the scales was assessed by interviews with 65 subjects, and there were high correlations between interviewers' ratings and subjects' ratings (.85 for Care, .69 for Overprotection). Later studies established that PBI responses are extremely consistent over time, with test-retest reliability across 11 years ranging from 0.72 – 0.56 (Wilhelm & Parker, 1990; n = 163). This was slightly better than the personality measures used in the same study, which included measures of neuroticism, self-esteem, and dependency. Parker et al (1979) noted no respondent sex or age effects on the scores. However, participants rated their mothers as both more caring and more overprotective than their fathers. There was a weak but significant relationship between social class and Care, with higher class being associated with more maternal Care.

One concern of some researchers with the PBI is assuring that participants adequately understand the items. Parker (1983, in Gamsa, 1987) noted that some participants had trouble understanding 5 items that involved double negatives. These items included statements such as “Did not praise me” and “Did not help me as much as I needed” (Gamsa, 1987, p 292). Gamsa states that Parker considered dropping these items, but did not because doing so somewhat compromised the validity of the scales. Gamsa re-wrote these items, eliminating the negative words (e.g. “Praised me”, “Helped me as much as I needed” p 292) and administered the edited PBI to 49 introductory psychology students. He found that the two scales were correlated at the level of previous test-retest correlations: .79 for maternal Care, .76 for maternal Overprotection, .81 for paternal Care and .84 for paternal Overprotection. Similar changes were also made by Stein et al. (2000b) in their child version of the PBI. Gamsa's study is weakened by a small sample size and a lack of validity indicators beyond correlation with the original PBI. Despite this he was able to show a large degree of correspondence between the two measures. Where language abilities are in question, such as in populations where English is a second language, Gamsa's revisions of the PBI would be a reasonable choice for researchers.

For use in this study, the PBI was scored as described by Parker et al (1979) for both scales, and was divided into groups at the sample mean. This division was used in order to be more culturally relevant, as it is expected that this sample of Chinese Americans will score differently from Parker's normative sample. The Chinese Americans will only be compared to their own group mean, thus at least partially allowing for healthy variations in parenting across cultures. This study also employed Gamsa's (1987) revisions of the PBI as many participants use English as a second language, and may have difficulty with negatively worded statements on the original PBI.

Cultural Beliefs and Behaviors Adaptation Profile: (Shiang & Bogumill, 2001) As described above, the CBBAP measures both cultural beliefs and behaviors across 3 domains: Family, Social and Work. There are a few problems with the use of this scale. Although it has been demonstrated to have reasonable reliability and validity (Gartstein, Shiang & Bogumill, 2001, Bogumill, 1998), it has not been used in a great deal of literature to date, and thus its properties are not well known. Also, given that items were generated from interview data with Chinese-Americans, it may be possible that many items will not be appropriate measures of culture change in other populations. Further studies with a wider variety of cultural groups are needed to see if these items and factors are appropriate measures of culture change for other minority or immigrant populations. However, it is clearly appropriate for use with the current sample, which consists exclusively of Chinese Americans.

Factor analysis of 150 items was carried out with only 180 subjects, so the factors generated by Bogumill (1998) may not be very stable. In this study, theoretical domains were used, as opposed to statistically derived factors, due to the likelihood that the factors were unstable due to insufficient sample size in the factor analysis study. Furthermore, the theoretical factors facilitate interpretation of results. After due consideration of these limitations, the CBBAP was still an ideal choice of measures for examining culture change within groups of Chinese-Americans, as it provided scores on several scales, giving a more complex and realistic description of the differences in culture change across individuals.

The CBBAP is also capable of being scored for discrepancies between beliefs and behaviors. In this study, 2 methods for calculating discrepancies were employed:

Positive Discrepancies: The first method for scoring discrepancies used in this study was based on the work of Higgins (1987). Higgins looked at discrepancies between beliefs and behaviors as predictors of negative affect. He asked subjects to rate the degree to which they possessed or wanted to possess certain traits. Item pairs were scored as a match if they differed by no more than one point, and as a discrepancy if they differed by 2 or more points. The total number of discrepancies were then counted. This technique was employed on the 18 belief-behavior item pairs on the CBBAP. Each item pair was compared, and counted as a positive discrepancy if the responses on the two items differed by more than one point. The total number of positive discrepancies were then counted, for the entire CBBAP as well as in each domain.

Directional Discrepancies: The Higgins method, while being grounded in past work on discrepancy theory, leaves out significant information about the discrepancies. In particular, the direction of the discrepancy is ignored. We do not know if the belief is more independent than the behavior, only that they differed. Because of this, a second method of scoring discrepancies was developed. The rating for each behavior item was subtracted from the rating on each matching belief item , and these directional discrepancies were totaled (behavior – belief = directional discrepancy). Totals are derived again for the total CBBAP and for each domain. A positive Directional Discrepancy score would indicate that beliefs are more independent than behaviors, while a negative Directional Discrepancy score would indicate that beliefs are more interdependent than behaviors.

Depression: The Beck Depression Inventory (Beck, Rush, Shaw & Emery, 1979) and the Chinese Depression Inventory (Zheng & Lin, 1991) were used as measures of depression. The BDI attempts to provide an etic definition of depression, based on DSM symptomatology. The CDI is an emic approach to the measurement of depression, created because Chinese subjects endorsed few feeling-related items on the BDI. The CDI therefore employs more language that is idiomatic and describes feeling states in the words Chinese participants would be likely to choose. It also includes several more items relating to somatization of depression feelings. (Zheng & Lin, 1991) A third measure of depression was included to allow for the fact that some participants may have a tendency towards depression, but were not depressed at the time they participated. This was limited to endorsement of a single item addressing lifetime history of depression. (Item text: “Have you ever had a period that lasted at least one week when you were bothered by feeling unhappy, sad, hopeless, heavy in your heart, depressed, that you did not care anymore, or did not enjoy anything? Yes/No”) Given that there is no control here for the severity of symptoms, it should best be thought of as an indicator of a lifetime history of at least sub-clinical depression.

General Distress: The SCL-90-R (Derogatis, 1992) was used as a measure of general psychological distress. This 90 item questionnaire asks participants to rate how much they have been bothered by a wide array of psychological symptoms. The average weight of all responses was calculated as a measure of generalized distress. T-scores for non-clinical samples were used as the sample in this study is a community-based sample.

CHAPTER IV

IV RESULTS..........

Characteristics of the Sample

Demographics: Demographic characteristics of the sample are summarized in Table 4.1. The sample has an over-representation of women (61.4%), and consists of mostly younger adults (18-29, 43.1%) The mean age was 35.9 years with a standard deviation of 14.65. The sample is roughly evenly split between married and single individuals, and 36.2% have at least one child. Most participants are highly educated, with 85% having a college education or better. The sample is of relatively low-to-average income for the area, with a median of $50,000-$64,999 per year (median household income Santa Clara county: $74,335, San Mateo County $70,819, US Census Bureau, 2004a,b), and consists largely of individuals in professional/technical careers (50.8 %). Socio-economic characteristics are shown in detail in Table 4.2. Culturally, the sample consists of more than half first generation immigrants (59.8%), most from China, Taiwan and Hong Kong. Most of those born in the US are second generation Asian-Americans (33.7% of sample). Further cultural data is listed in Table 4.3.

Cultural beliefs and behaviors: The total CBBAP score for this sample lies very close to the theoretical midpoint of the scale (m = 3.49, SD = .43, scale midpoint = 3.5). The family domain was significantly less independent, and the social domain was significantly more independent, compared to the global mean. Overall, beliefs were slightly less independent than behaviors . This pattern was much stronger in the family domain, whereas the opposite was true in the Work domain (See Table 4.4 for exact

Table 4.1

Demographic Characteristics of the Sample

Age groups	n	Percent

18-29	106	43.1

30-39	63	25.6

40-49	40	16.3

50 and older	37	15.0

(Mean Age = 35.9, SD = 14.65)

Gender	n	Percent

Male	95	38.6

Female	151	61.4

Marital Status	n	Percent

Single/never married	104	42.3

Married	110	44.7

Divorced	13	5.3

Other	19	7.7

Number of Children	n	Percent

0	157	63.8

1	26	10.6

2	41	16.7

3 or more	22	8.9

Table 4.2

Socio-economic Characteristics of the Sample

Education (completed)	n	Percent

Middle School	1	0.4

High School	29	11.8

Trade/Vocational School	7	2.8

College (2 or 4 year)	132	53.7

Graduate School	77	31.3

Occupation	n	Percent

Professional/Technical	125	50.8

Management/Clerical	37	15,0

Skilled/Semi-skilled Labor	14	5.7

Student	46	18.7

Not in labor force	22	8.9

Income	n	Percent

less than $15,000	17	6.9

$15,000 - $24,999	17	6.9

$25,000 - $34,999	21	8.5

$35,000 - $49,999	45	18.3

$50,000 - $64,999	40	16.3

$65,000 - $99,999	45	18.3

$100,000 or more	59	24.0

Table 4.3

Cultural Characteristics of Sample

Country of birth	n	Percent

People's Republic of China	40	16.3

Taiwan	46	18.7

Hong Kong	38	15.4

United States	99	40.2

Other	23	9.3

Years lived in US	n	Percent

Born in US	99	40.2

0-10 years	30	12.2

11-20 years	63	25.6

21-30 years	30	12.2

more than 30 years	24	9.8

Generation status	n	Percent

1st generation (immigrant)	147	59.8

2nd generation	83	33.7

3rd generation	8	3.3

4th generation	8	3.3

means, t-tests and significance). There was a mean of 3.84 (SD = 2.37) discrepancies across the 18 item pairs. There were fewer discrepancies on average in the Family and Work domains, and more in the Social domain (see Table 4.4). Overall Directional discrepancies showed a pattern that beliefs tend to be more independent than behaviors. This contradicts the slight differences shown above, and may be related to scores in the domains rather than reflecting an overall trend. Only in the Family Domain were beliefs less independent than behaviors (see Table 4.4)

CBBAP scores were associated with some of the demographic variables (see Table 4.5 for statistics on all comparisons). Age, gender, marital status, number of children, occupation and country of origin were not related to any CBBAP variables. Education was related to independence across all domains, with more education associated with more independence. Income showed a similar trend, with higher incomes related to higher independence in the Family and Social (but not Work) domains. Generation status was related only to the Family domain, with more generations in the US associated with higher Independence in the family domain. Years in the US (for immigrant participants only) was not related to any independence variables, but was correlated with Positive Discrepancies, in that those who had lived in the US longer showed more discrepancies between their cultural beliefs and behaviors.

Parental Bonds: Parental bonds in this sample differed from Parker et al's (1979) original sample across all four scales. Both parents were rated as higher in Care and higher in Overprotection than the original sample (see table 4.6 for means, t tests and significance). 94 mothers and 82 fathers were rated above the mean for Care and below

Table 4.4

Sample Characteristics: CBBAP scores

Independence/Interdependence

Domain	Item average Domain vs Total Beliefs Behaviors Beliefs vs. Behaviors M (SD) t (sig) M (SD) M (SD) t (sig)
Total	3.49 (.43)	-		3.46 (.40)	3.52 (.53)	2.16 (.032)*
Family	3.21 (.65)	11.65 (.000)**		2.87 (.67)	3.41 (.72)	15.85 (.000)**
Social	3.76 (.58)	12.15 (.000)**		3.76 (.62)	3.75 (.72)	0.10 (.917)
Work	3.51 (.37)	0.67 (.503)		3.62 (.38)	3.39 (.51)	7.76 (.000)**
Positive Discrepancies (# of all item pairs with responses differing by more than 1 point)
Domain	Total Average Domain vs Total vs Family vs Social M (SD) M (SD) t (sig) t (sig) t (sig)
Total	3.84 (2.37)	.213 (.13)	-	-	-
Family	0.72 (0.82)	.147 (.16)	7.54 (.000)**	-	-
Social	2.09 (1.55)	.352 (.26)	11.42 (.000)**	10.74 (.000)**	-
Work	0.99 (1.13)	.141 (.16)	9.19 (.000)**	0.55 (.581)	11.08 (.000)**
Directional Discrepancies (behavior – belief = directional discrepancy)
Domain	Total Average Domain vs Total vs Family vs Social M (SD) M (SD) t (sig) t (sig) t (sig)
Total	2.46a (6.68)	.137 (.37)	-	-	-
Family	-1.43 (2.48)	-.289 (.50)	13.32 (.000)**	-	-
Social	3.49 (4.96)	.586 (.83)	11.74 (.000)**	13.69 (.000)**	-
Work	0.40 (3.15)	.066 (.53)	2.54 (.012)*	7.99 (.000)**	8.56 (.000)**

* Sig. at  = .05	** Sig. at  = .001

a Positive scores indicate behaviors are more independent than beliefs, while negative scores indicate the reverse.

Table 4.5

CBBAP – Demographic comparisons

	CBBAP Domain Total Family Social Work	Positive Discrepancies	Directional Discrepancies
Age	r = -.03a	r = -.08	r = .03	r = -.02	r = .05	r = .07
Gender	t = -1.01b	t = -0.37	t = -1.60	t = -0.26	t = -0.44	t = 1.08
Marital Status	f = 0.76c	f = 1.34	f = 2.20	f = 1.91	f = 0.31	f = 0.72
# Children	r = .01	r = -.02	r = .04	r = -.00	r = .07	r = .05
Education	r = .20**	r = .14*	r = .19**	r = .13*	r = -.04	r = -.07
Occupation	f = 1.65	f = 1.70	f = 1.39	f = 1.45	f = 1.68	f = 1.84
Income	r = .18**	r = .17**	r = .15*	r = .09	r = .04	r = .05
Country of Origin	f = 1.51	f = 1.20	f = 1.59	f = 0.80	f = 1.04	f = 0.65
Years in US	r = .04	r = -.01	r = .04	r = .08	r = .19*	r = .06
Generation Status	r = .08	r = .14*	r = .01	r = -.01	r = -.00	r = .04

* p < .05	** p < .01	***p < .001

a r indicates level of correlation in a continuous variable or a rank-ordered variable.

b t indicates difference between 2 groups in a nominal variable.

c f indicates difference between 3 or more groups in a nominal variable.

the mean for Overprotection. 62 mothers and 51 fathers were rated low Care and high Overprotection. For other quadrants and tallies across both parents, see Table 4.6.	PBI scores were associated with some of the demographic variables (see Table 4.7 for statistics on all comparisons). Education, years in US, and generation status were not related to the PBI. Age and number of children were related to both parents' Care and mother's Overprotection, in that older participants and those with more children rated parents as higher in Care and mothers as lower in Overprotection. Women reported their fathers as more Overprotective than men reported their fathers to be. Occupation was related to mother's Overprotection. Participants not in the labor force rated their mothers as lowest in Overprotection (m = 12.41, SD = 4.17), while those in Management/Clerical positions rated their mothers high in Overprotection (m = 17.69, SD = 5.7). Income showed a different trend, with those making more money reporting greater care from their fathers. Country of origin was related to father's Overprotection, with those from Taiwan reporting more Overprotection (m = 16.20, SD = 5.15) than those from China (m = 14.18, SD = 4.49), Hong Kong (m = 13.89, SD = 5.57), or the United States (m = 12.84, SD = 5.01).

Because of a possible confound between greater age and age at relocation to the US, the correlations between age and PBI scales were re-examined through regression analyses, with age at relocation to the USA entered first as a control variable. Age at relocation was significantly related to Care for both parents, with participants older at relocation reporting more care than those who were younger at relocation (Mother's Care: R = .20, F= 9.87, p = .002; Father's Care: R = .16, F= 6.41, p = .012). Partial

Table 4.6

Sample Characteristics: Parental Bonding

PBI - Scale Scores
	Current sample Original Sample (Parker et al 1979) Difference M SD M SD t sig
Mother	Care 28.69 5.80 26.8 not given 5.05*** .000 Overprotection 15.87 5.70 14.7 “ 3.18** .002
Father	Care 26.18 6.74 22.9 “ 7.51*** .000 Overprotection 14.20 5.22 11.9 “ 6.78*** .000

PBI – Quadrants

	 Care,  O-P  Care,  O-P  Care,  O-P  Care,  O-P N % N % N % N %
Mother	94	38.2	56	22.8	25	10.2	62	25.2
Father	82	33.3	49	19.9	53	21.5	51	20.7
	Both Parents	Mom Only	Dad Only	Neither Parent
 Care,  O-P	53	21.5	37	15.0	28	11.4	110	44.7
 Care,  O-P	28	11.4	33	13.4	21	8.5	146	59.3

* p < .05	** p < .01	***p < .001

Table 4.7

PBI – Demographic Comparisons

	Care Overprotection Mother Father Mother Father
Age	r = .18**	r = .15*	r = -.21***	r = -.10
Gender	t = 1.10	t = 1.00	t = -1.69	t = -2.26*
Marital Status	f = 2.03	f = 1.46	f = 4.25***	f = 2.23*
# Children	r = .14*	r = .14*	r = -.19**	r = -.11
Education	r = .07	r = .09	r = -.06	r = -.05
Occupation	f = 1.66	f = 1.74	f = 3.06*	f = 2.19
Income	r = .06	r = .15*	r = -.10	r = -.13
Country of Origin	f = 1.14	f = 1.03	f = 1.28	f = 2.24**
Years in US	r = -.10	r = .01	r = .01	r = .05
Generation Status	r = -.01	r = .01	r = .05	r = -.12

* p < .05	** p < .01	***p < .001

correlations between age and Care were no longer significant when age at relocation was controlled for (Mother's Care: r = .11, p = .101; Father's Care: r = .10, p = .129), indicating that older participants were more likely to have relocated to the US at an older age and therefore viewed their parents as more caring. Age at relocation to the US was not significantly related to Overprotection (Mother's OP: R = .08, F = 1.468, p = .23; Father's OP: R = .06, F = 0.97, p = .33). Partial correlations between mother's Overprotection and age remained significant when age at relocation was controlled for (r=-.20, p = .002) indicating that older participants viewed their mothers as less overprotective regardless of their age at relocation.

Depression and Psychological Distress: Many participants in the sample reported significant levels of depression and distress. 43 (17.5%) were above the cutoff for mild or greater depression on the BDI. 30 (12.2%) were above the cutoff for mild or greater depression on the CDI, and 36 (14.6%) were above the cutoff for significant general distress. Further, over half the sample (131, 53.3%) reported a history of prior depressive symptoms lasting at least a week. See Table 4.8 for additional information.

Table 4.8

Sample Characteristics: Depression and Distress

Scale	M	SD	Cutoff	N above cutoff	% above cutoff
Beck Depression Inventory	5.28	5.88	10	43	17.5
Chinese Depression Inventory	10.63	10.18	25	30	12.2
History of Depression	0.53	0.50	1	131	53.3
SCL-90-R Global Severity Index	52.16	11.57	65	36	14.6

Depression and distress scores were associated with all demographic variables except country of origin (see Table 4.9 for this and other comparisons). Younger subjects reported more depression on the CDI and more distress. Women (m=6.13, SD = 6.49) reported more depression than men (m = 3.95, SD = 4.45) on the BDI, but were identical on other measures. Married participants were less likely to have a history of depression (m = .40, SD = .49) than those who had never married (m = .66, SD = .47) or those who had divorced(m = .77, SD = .44) but did not differ on current symptomatology. Similarly, participants with children were less likely to report a history of depression. Less educated and lower income participants reported more depression on the BDI and CDI, and more distress. Occupation was related to all 4 measures (see Table 4.10). In general, this occurred because the 5 participants who were Semi-skilled laborers had higher depression and distress scores. However, professional/technical participants reported less depression on both BDI and CDI and less distress than students and management/clerical participants, while those not in the labor force reported less history of depressive symptoms than all other groups. Finally, immigrants with fewer years in the US showed higher depression across all measures, and earlier generation status was associated with greater distress (see Table 4.9 for all comparisons).

Question 1: Is there a direct relationship between patterns of parental bonds and depression, or is this relationship better accounted for by general psychological distress?

Before conducting regression analyses, correlations were calculated between the measures of psychopathology and the PBI scores (see Table 4.11). The BDI and CDI were highly intercorrelated. General distress was moderately correlated with the BDI and

Table 4.9

Depression and distress: Demographic Comparisons

	Beck Depression Inventory	Chinese Depression Inventory	History of Depression	SCL-90-R Global Severity Index
Age	r = -.10	r = -.20**	r = -.24	r = -.13*
Gender	t = -3.12**	t = -1.21	t = -0.21	t = 0.32
Marital Status	f = 1.62	f = 1.72	f = 3.54***	f = 1.26
# Children	r = -.06	r = -.11	r = -.18**	r = -.12
Education	r = -.26***	r = -.27***	r = -.10	r = -.23***
Occupation	f = 4.23***	f = 4.87***	f = 3.88**	f = 4.86***
Income	r = -.27***	r = -.20***	r = -.10	r = -.26***
Country of Origin	f = 1.58	f = 1.67	f = 1.21	f = 1.51
Years in US	r = -.20*	r = -.18*	r = -.21*	r = -.15
Generation Status	r = -.03	r = -.02	r = -.08	r = -.14*

* p < .05	** p < .01	***p < .001

Table 4.10

Mental Health and Occupation

	n	BDI CDI Dep Hist Distress m (SD) m (SD) m (SD) m (SD)
Professional/Technical	125	3.82(4.42)	8.38(8.64)	.52(.51)	50.07(11.13)
Management/Clerical	37	7.46(6.80)	12.11(11.13)	.62(.49)	57.03(13.02)
Skilled labor	9	7.11(6.09)	15.89(12.84)	.56(.53)	55.67(11.27)
Semi-skilled labor	5	10.40(8.59)	24.40(9.45)	1.00(.00)	65.00(8.16)
Not in work force	22	4.96(4.96)	9.00(7.67)	.18(.39)	47.23(10.49)
Student	46	6.09(6.57)	13.22(11.18)	.63(.49)	53.91(9.84)
f	-	f = 4.23***	f = 4.87***	f = 3.88**	f = 4.86***

***p < .001

Table 4.11

Correlations between depression/distress and PBI

	SCL-90-R Global Severity Index	Beck Depression Inventory	Chinese Depression Inventory	History of Depression
Mother's Care	-.128*	-.228***	-.199***	-.202***
Father's Care	-.170**	-.244***	-.213***	-.113*
Mother's Overprotection	.096	.261***	.192***	.216***
Father's Overprotection	.124*	.204***	.108*	.179**
SCL-90R	-	.586***	.645***	.339***
BDI	-	-	.749***	.229***
CDI	-	-	-	.311***

* p < .05	** p < .01	***p < .001

CDI. History of depression was mildly correlated with the other psychopathology variables. PBI scores were mildly correlated with all measures of psychopathology, with the exception of mother's Overprotection and general distress. In general, Care showed a negative relation with psychopathology, and Overprotection a positive relationship. Correlations were highest with the BDI and lowest with general distress.

Regression analyses were conducted with each of the 3 measures of depression as the dependent variable. In each analysis, general distress was entered in the first step, and all 4 PBI scales were entered simultaneously in the second step. Results are displayed in Table 4.12. Overall, the regression analyses show that the PBI variables continue to be significantly predictors of depression when generalized distress is

Table 4.12

Regression Analyses: PBI, Distress and Depression

Regression
	R	R2 Change	F change	Significance
Beck Depression Inv.				
General Distress	.596	.355***	122.84	.000
All PBI Variables	.641	.055***	5.12	.001
Chinese Depression Inv.				
General Distress	.653	.426***	165.38	.000
All PBI Variables	.671	.025*	2.48	.045
History of Depression				
General Distress	.332	.110***	27.56	.000
All PBI Variables	.399	.049*	3.18	.015
Partial Correlations
	Care Overprotection Mother Father Mother Father
BDI	-.208**	-.168*	.258***	.177**
CDI	-.163*	-.125	.157*	.035
Hist Depression	-.159*	-.067	.205**	.150*

* p < .05	** p < .01	***p < .001

controlled for. BDI scores were the best predicted for. They had significant partial correlations with all four PBI scales. PBI scales together explained 5.5% of the variance in depression beyond that explained by general distress. History of depression was also highly associated with the PBI, with an additional 4.9% of its variance explained by PBI scores. It had significant partial correlations with all PBI variables except father's Care. the CDI was the least associated with the PBI when general distress was controlled for. PBI variables explained only an additional 2.5% of variance in CDI scores, and significant partial correlations were small and were found only for mother's Care and Overprotection. See Table 4.12 for exact values.

Question 2: Are cultural values as measured by the CBBAP associated with patterns of parental bonds?

Correlations were computed between each PBI scale and all the scales of the CBBAP. Results are displayed in Table 4.13. There were many associations found between CBBAP scales and PBI scales. Overall, greater independence was associated with reports of less Care from both parents, but showed no association with Overprotection. This effect was strongest in the family domain, with correlations of -.485 for mothers and -.455 for fathers. The effect remained significant in the Work and Social domains as well. Overprotection was only associated with independence in the family domain. Greater independence in family beliefs was associated with perceiving greater overprotection from one's mother. Discrepancies showed far fewer relationships. Positive discrepancies were associated with higher reports of father's Care. This held true only in the social domain. Positive directional discrepancies (beliefs more independent

Table 4.13

Correlations between CBBAP and PBI

	Care Overprotection Mother Father Mother Father
CBBAP total	-.387***	-.373***	.073	-.002
Beliefs	-.330***	-.308***	.118	-.014
Behaviors	-.365***	-.358***	.026	-.001
Family domain	-.485***	-.455***	.158*	.058
Beliefs	-.430***	-.422***	.202**	.092
Behaviors	-.454***	-.412***	.107	.023
Social Domain	-.154*	-.192**	-.054	-.071
Beliefs	-.095	-.130*	.001	-.085
Behaviors	-.161*	-.191**	-.085	-.044
Work Domain	-.225***	-.177**	.058	.005
Beliefs	-.219***	-.120	.067	-.024
Behaviors	-.163*	-.173**	.011	.015
Positive Discrepancies: Total	.062	.132*	.040	-.048
Family Domain	.024	-.015	-.016	.055
Social Domain	.075	.136*	.029	-.059
Work Domain	-.007	.073	.042	-.058
Directional Discrepancies: Total	-.084	-.037	.152*	-.002
Family Domain	-.081	-.083	.157*	.032
Social Domain	-.065	.067	.087	-.040
Work Domain	-.001	-.091	.103	.044

* p < .05	** p < .01	***p < .001

than behaviors) were associated with perceiving greater maternal overprotection. This held true only in the family domain.

Patterns of parental bonds were examined only where 2 or more PBI scores correlated with an individual CBBAP score. Results are displayed in table 4.14. In general, participants who rated both parents as high in care described themselves as less independent than those with only one parent high in Care, who were in turn less independent than those with neither parent high in Care. This pattern did not hold true in the work and social domains, largely because the differences were smaller and participants with one parent high in Care tended not to differ from other groups. A different pattern was seen with total scores and overall belief scores. For these scales, participants rating one or both parents as high in Care described themselves as less independent than participants rating neither parent as high in Care. For comparisons on mothers quadrants in the family domain, the stronger relationship with Care completely overpowered the weaker relationship with Overprotection, so that both high Care quadrants were lower than both low Care quadrants.

Question 3: Is there an interaction between parental bonds and cultural values in predicting depression and psychological distress?

Several three-way ANOVAS were conducted to examine interactions between PBI variable and culture in predicting depression. BDI scores were used as the dependent variable in all cases, as they showed the strongest relationship with the PBI in question 1 (see Tables 4.11 & 4.12). Identical calculations were carried out for each parent. Each ANOVA had three independent variables. The first was parental Care,

Table 4.14

CBBAP scores and patterns of parental bonds

Patterns of parental Care: a
	Both parents high Care	Mom only high Care	Dad only high Care	Neither parent high Care
CBBAP total	3.34 (.37) -	3.48 (.33) -	3.51 (.38) -	3.73 (.42) +
Beliefs	3.36 (.35) -	3.44 (.31) -	3.44 (.36) -	3.66 (.45) +
Behaviors	3.33 (.48) -	3.51 (.41) =	3.58 (.46) =	3.79 (.57) +
Family domain	2.91 (.53) -	3.24 (.48) =	3.25 (.67) =	3.65 (.69) +
Beliefs	2.60 (.56) -	2.96 (.49) =	2.84 (.71) =	3.27 (.71) +
Behaviors	3.11 (.63) -	3.40 (.56) =	3.49 (.69) =	3.88 (.76) +
Social Domain	3.67 (.55) -	3.77 (.53)	3.76 (.53)	3.89 (.64) +
Behaviors	3.62 (.65) -	3.79 (.72)	3.85 (.82)	3.89 (.76) +
Work Domain	3.44 (.34) -	3.41 (.34) -	3.53 (.38)	3.63 (.42) +
Behaviors	3.30 (.46) -	3.32 (.42)	3.38 (.48)	3.51 (.50) +
Patterns of maternal bonds (quadrants): a
	 Care,  O-P	 Care,  O-P	 Care,  O-P	 Care,  O-P
Family domain	2.98 (.49) +	3.04 (.60) +	3.55 (.62) -	3.56 (.72) -
Beliefs	2.65 (.54) +	2.79 (.62) +	3.10 (.62) -	3.19 (.75) -

a Scores show are mean and (standard deviation)

+ Group of scores significantly higher than those marked – or = (p < .05)

= Group of scores between high (+) and low (-) scores (p < .05)

- Group of scores significantly lower than those marked + or = (p < .05)

No mark indicates not significantly different from other scores

divided at the sample mean for each parent. The second was parental Overprotection, again divided at the mean for each parent. The third was a CBBAP scale. Independence and positive discrepancy scales were divided at the sample mean. Directional discrepancy variables were divided into 3 groups: beliefs more independent (positive scores), beliefs and behaviors equally independent (scores of 0), and behaviors more independent (negative scores). Initial comparisons were carried out for the total scale of each CBBAP category (Independence, Positive Discrepancies, Directional Discrepancies), and then significant interactions were examined across domains for that category. Results for these initial comparisons are displayed in Table 4.15.

Main effects were generally seen for Care and Overprotection for both parents, but not for CBBAP variables. For both mothers and fathers, higher Care was associated with fewer depressive symptoms, and higher overprotection was associated with more depressive symptoms. There was one significant interaction for both parents with the CBBAP total Independence score (see Table 4.15; and Figure 4.1 for mothers and 4.4 for fathers). Low Care was only associated with higher scores of depression for participants who were low in Independence. This effect was replicated in all 3 domains (see Table 4.16).

There was one significant 2 way interaction for positive discrepancies, again for both parents (see Table 4.15 and Figures 4.2 for mothers and 4.5 for fathers). High Overprotection was only associated with higher scores of depression for those who reported few discrepancies between beliefs and behaviors. There was a 3 way interaction between father's Care, father's Overprotection and positive discrepancies (see Table 4.15

Table 4.15

Interactions between Culture and Parental Bonds in predicting Depression: Main Comparisons

Mothers	F	Sig.	Fathers	F	Sig.
Care	6.803**	.010	Care	13.288***	.000
Overprotection (OP)	6.090*	.014	Overprotection (OP)	5.654*	.018
CBBAP total	0.849	.358	CBBAP total	1.161	.282
Care X OP	0.736	.392	Care X OP	3.383	.067
Care X CBBAP	3.995*	.047	Care X CBBAP	9.671**	.002
OP X CBBAP	0.130	.718	OP X CBBAP	2.327	.129
Care X OP X CBBAP	2.004	0.16	Care X OP X CBBAP	2.299	.131
Care	6.251*	.013	Care	11.574***	.001
Overprotection (OP)	5.190*	.024	Overprotection (OP)	3.108	.079
Positive Discrep. (PD)	2.524	.114	Positive Discrep. (PD)	4.396*	.037
Care X OP	0.610	.436	Care X OP	2.840	.093
Care X PD	0.021	.885	Care X PD	0.343	.559
OP X PD	7.975**	.005	OP X PD	4.160*	.043
Care X OP X PD	0.073	.787	Care X OP X PD	4.218*	.041
Care	2.324	.129	Care	2.689	.102
Overprotection (OP)	6.839**	.010	Overprotection (OP)	4.045*	.046
Directional Discr. (DD)	0.483	.617	Directional Discr. (DD)	0.996	.371
Care X OP	1.802	.181	Care X OP	3.103	.080
Care X DD	1.193	.305	Care X DD	0.961	.384
OP X DD	2.995 a	.052	OP X DD	1.352	.261
Care X OP X DD	0.932	.395	Care X OP X DD	0.572	.565

* p < .05	** p < .01	***p < .001	a approaches significance

Table 4.16

Interactions between Culture and Parental Bonds in predicting Depression: Domains

Mothers	F	Sig.		Fathers	F	Sig.
Care	7.394**	.007		Care	10.624***	.001
Overprotection (OP)	6.327*	.013		Overprotection (OP)	6.837**	.010
CBBAP Family	0.921	.338		CBBAP Family	0.556	.456
Care X OP	1.413	.236		Care X OP	4.096*	.044
Care X CBBAP	5.289*	.022		Care X CBBAP	7.749**	.006
OP X CBBAP	0.074	.786		OP X CBBAP	1.887	.171
Care X OP X CBBAP	1.040	.309		Care X OP X CBBAP	2.520	.114
Care	7.381**	.007		Care	14.125***	.000
Overprotection (OP)	4.167*	.042		Overprotection (OP)	5.744*	.017
CBBAP Social	4.103*	.044		CBBAP Social	4.025*	.046
Care X OP	0.400	.528		Care X OP	2.131	.146
Care X CBBAP	5.011*	.026		Care X CBBAP	7.360**	.007
OP X CBBAP	1.765	.185		OP X CBBAP	0.320	.572
Care X OP X CBBAP	0.027	.870		Care X OP X CBBAP	4.444*	.036
Care	6.944**	.009		Care	11.190***	.001
Overprotection (OP)	6.448*	.012		Overprotection (OP)	5.524*	.020
CBBAP Work	1.932	.166		CBBAP Work	1.037	.310
Care X OP	0.977	.324		Care X OP	2.158	.143
Care X CBBAP	8.086**	.005		Care X CBBAP	5.212*	.023
OP X CBBAP	0.012	.912		OP X CBBAP	0.294	.588
Care X OP X CBBAP	1.563	.213		Care X OP X CBBAP	2.031	.155

* p < .05	** p < .01	***p < .001

and Figure 4.6). This 3-way interaction modified the pattern seen in the 2-way interaction (Figure 4.5). The interaction between discrepancies and Overprotection only occurred when fathers showed High Care. When fathers showed Low Care, participants reported higher depression regardless of their scores on other scales. These effects were explored across the 3 domains (see Table 14.17). For mothers, the Overprotection X positive discrepancy interaction was significant only in the Family and Work domains. For fathers, only the 3-way interaction remained significant, and only in the Social domain. The pattern for each of these 3 interactions was the same as seen in the main comparisons.

No interactions were significant for directional discrepancies. However, the interaction between mother's Overprotection and directional discrepancies approached significance. As can be seen in Figure 4.3, this non-significant trend replicates the Overprotection X positive discrepancy interaction, in that those reporting beliefs and behaviors equally independent showed the same pattern as those with few discrepancies, and those reporting either beliefs or behaviors as more independent showed a similar pattern to those with many discrepancies. Because this trend was not significant, no follow-up analyses were carried out across domains.

Table 4.17

Interactions between Culture and Parental Bonds in predicting Depression: Positive Discrepancies

Mothers	F	Sig.		Fathers	F	Sig.
Care	8.360**	.004		Care	11.658***	.001
Overprotection (OP)	5.514*	.020		Overprotection (OP)	4.162*	.043
Positive Discr. Family (PDF)	0.020	.888		Positive Discr. Family (PDF)	0.056	.813
Care X OP	1.113	.293		Care X OP	2.133	.146
Care X PDF	0.001	.976		Care X PDF	0.353	.553
OP X PDF	5.772*	.017		OP X PDF	2.671	.104
Care X OP X PDF	2.287	.132		Care X OP X PDF	1.629	.203
Care	6.510*	.011		Care	14.400***	.000
Overprotection (OP)	4.411*	.037		Overprotection (OP)	3.476 a	.064
Positive Discr. Social (PDS)	2.543	.112		Positive Discr. Social (PDS)	1.071	.302
Care X OP	1.676	.197		Care X OP	0.544	.462
Care X PDS	0.255	.614		Care X PDS	1.847	.176
OP X PDS	0.608	.437		OP X PDS	0.356	.551
Care X OP X PDS	1.438	.232		Care X OP X PDS	6.655*	.011
Care	5.818*	.017		Care	10.895***	.001
Overprotection (OP)	6.007*	.015		Overprotection (OP)	3.538 a	.061
Positive Discr. Work (PDW)	1.480	.225		Positive Discr. Work (PDW)	2.519	.114
Care X OP	0.463	.497		Care X OP	2.914	.089
Care X PDW	0.076	.783		Care X PDW	0.310	.578
OP X PDW	4.704*	.031		OP X PDW	0.816	.367
Care X OP X PDW	0.114	.735		Care X OP X PDW	0.500	.480

* p < .05	** p < .01	***p < .001	a approaches significance

Note: Trend only, approaches but does not reach significance

CHAPTER V

V DISCUSSION.......

The current study adds much to our understanding of parental bonds, both in general, and in non-western cultures. This research sample responded very differently to the PBI than has been seen in past studies. Participants rated parents as more Caring and more Overprotective than the means reported from the standardization sample (Parker et al, 1979). This contrasts with the typical results in non-western samples (see Table 1.3), in regards to parental Care. Only one study to date has shown a non-western sample to report more Care than western participants (Canetti et al., 1997). This was found in a native community sample in Israel. It is possible there is something in the immigration experience of this study's participants as compared to previous immigrant samples that explain the differences seen on Care. California's Bay Area is somewhat unique. It has a large and thriving Chinese community that has been well-established for over a century, and may offer social supports unavailable to the Vietnamese and Indian samples described in Table 1.3. Chinese American immigrants in this sample may also have experienced higher levels of prosperity than other immigrant samples. Higher incomes were associated with higher perceptions of paternal Care in this study, and with Care from both parents in the standardization sample (Parker et al, 1979). In summary, the differences between this sample and other non-western samples suggests that it may be negative immigration experiences (such as poverty, lack of social support, and difficulties acculturating), and not culture itself, that cause children to describe their parents as less Caring.

It is interesting to compare these findings to the cross cultural attachment studies described above. In two Interdependent cultures (Japan and Puerto Rico), it was shown that the nature of a healthy infant attachment differs from a healthy infant attachment in the west. In particular, while maternal emotional sensitivity (the analog of Care on the PBI) showed the same relationship with secure attachments in both Puerto Rico and the United States, Control (a possible analog of Overprotection on the PBI) showed a very different relationship in the two cultures (Carlson & Harwood, 2003). Parents of secure Puerto Rican infants used much more control than parents of secure American infants. Similar trends were seen in the cultural underpinnings of parenting and attachment in Japan (Rothbaum et al., 2000). In this Chinese American sample, greater Overprotection was seen when compared to the normative, western sample, as well as greater Care. This Overprotection, like the control observed by Carlson and Harwood (2003), may be an indicator of more secure and culturally appropriate parent-child bonds, rather than an indicator of dysfunction and discord.

Immigration history was also related to participants perception of their parents. There was a positive correlation found between participants age at relocation to the US and their perception of Care from both parents. Those who were raised in Asia were more likely to rate their Asian parents high in Care than those who were raised predominantly in the US. It is likely that these participants raised in Asia were judging Care by a more Asian understanding, and therefore did not see their parents as cold or hard to talk to. The participants raised in the US however, would likely have judged their Asian parents from a western standard of Care, and their responses might indicate a culture gap rather than an actual lack of care on the part of the parents. This correlations between age at relocation and perception of parental care may further explain why the current sample reported more care than other non-western samples. The majority of studies listed on table 1.3 were conducted with teens and young adults. Most of these participants would have spent at least part of their formative years in western nations. They might have therefore consistently reported lower care. Perhaps the mean score for Care in this sample was higher in part because the current study includes older participants and many participants raised entirely in Asia, and thus were able to perceive care in the manner in which their parents showed it.

One cultural difference was seen with PBI scores between groups of Chinese Americans. In particular, those born in Taiwan reported more overprotection from fathers than those born in China, Hong Kong, or the United States. This may be related to ongoing hostilities between China and Taiwan. Parents would justifiably be more protective of their children in a country at war. Perhaps this difference was seen only in the behaviors of fathers due to a difference in the role of fathers and mothers. Fathers leave the home to earn income and are more involved in the troubles of the world outside the family, and thus might feel more need to protect children from a genuinely dangerous outside world.

Another important difference between this sample and past adult samples was the discovery of an age difference in reports of maternal Overprotection. This difference remained significant even when age at relocation to the US was controlled for. Past studies with children have only found age differences in care (Rey, Bird, Kopec-Schrader & Richards, 1993) whereas adult studies have not reported age differences on any PBI scales. Perhaps the inclusion of several elderly participants in the current study made it possible to see this trend. Much “adult” research is carried out with students and rarely includes as many as 15% of participants over the age of 50, as was seen in the current study. It is interesting to consider the implications of this cross-sectional finding as a potential developmental trend, indicating a possible shift in perception of mothers as one grows older. The shift to viewing mothers as less overprotective is consistent with parent self-reports (Parker, 1981a), and may consequently be a more accurate memory of parental actions. Perhaps a wide array of further life experiences after gaining independence from parents, particularly ones own experience in caring for significant others (children, spouses, parents, etc) allows for a more balanced or understanding view of one's parents' actions. This is supported by the finding that having children was also associated with reporting less overprotection from mothers. This effect was not seen with father's Overprotection. This may be because of the different roles of mothers and fathers. Mothers tend to have more day to day interaction with children, and are often the primary disciplinarians. It may be these discipline and daily interactions that older participants view differently.

This study also provided a better understanding of cultural adaptation. With use of the CBBAP (Shiang & Bogumill, 2001), it was shown that culture is not a unitary construct. Sample means for each domain of the CBBAP were significantly different, with beliefs and behaviors about family being more traditional or interdependent, and those about friends and social relationships being less traditional or more independent. It was also shown that, within domains, beliefs and behaviors vary. The participants of this study believed they should act more traditionally than they reported behaving towards their families, while they reported believing they should be more independent at work than they felt they actually were. This underscores the importance of considering culture from a multi-dimensional perspective. The participants int his sample clearly adapted the application of their culture to fit each setting. They were most traditional in relation to their families, while believing they should be even more traditional. In the work setting, they were moderately more independent, but wished they could be more so, possibly wishing they could imitate behaviors of western co-workers. In the social domain, participants reported being much more independent, with no overall difference between their beliefs and their behaviors. Each setting calls for different behaviors. Consideration of culture without considering the domain in which it is applied may find incorrect conclusions.

This sample had other unique characteristics. Most of the sample were technical professionals, clerical workers or students. However, there were 5 semi-skilled workers in the sample. The means for depression and distress in this group were above clinical cutoffs, and all 5 indicated a history of at least sub-clinical depressive episodes. These 5 people were unlikely to skew the results of a sample of 246, so they were included in all analyses. However, it is interesting to note the strong connection between depression and this class of laborers. In an area as affluent as California's Bay Area, it is potentially very difficult to make ends meet without a professional or technical salary. These 5 semi-skilled workers may have been facing conditions of economic disadvantage that would not be typical in other geographic areas, where semi-skilled labor would give an individual a good living wage.

Case Examples

Four case examples will be discussed to give the reader a better feel for who the participants were in this study. The first serves as an example of a semiskilled worker. The second serves as an example of a typical depressed participant, and meets many of the risk factors for depression described in the literature review. The final two cases provide examples protective factors of cultural beliefs and behaviors found in interactions. The exact nature of these protective factors will be discussed at length when the relevant findings are discussed.

Participant 4401 serves as a good case example of these 5 semiskilled workers mentioned above. This participant is a 32 year old man who was born in Hong Kong. He has lived in the United States for 14 years and lives alone, as he is divorced. He has one child. He completed high school and trade school and makes between $25,000 and $34,999 a year. This is more than the national per capita income ($21,587, US Census Bureau, 2004c) but less than the per capita income in the Bay Area (San Mateo County $36,045, US Census Bureau, 2004a). He has never sought help for emotional difficulties. His global distress T score is 77, above the cutoff for clinical significance. His BDI score is 20, indicating a moderate level of depression that is likely to be clinically significant, and his CDI score is 34, well above the 25 point cutoff for mild depression. He reports low Care and high Overprotection from both parents. He endorses independent cultural values in all domains, and has few discrepancies between his cultural beliefs and behaviors. Overall, participant 4401 has many risk factors for depression, including a low income, divorce status, recent immigration and dysfunctional parental bonds. All of these factors, combined with his occupation, lead to his expression of emotional distress.	Participant 224 represents a prototypical depression case in this sample, in that she has all major risk factors and none of the cultural protective factors that will be described in detail below. She is a 27 year old professional with a graduate degree who has never been married and has no children. Although her CDI score, at 26, is just above the cutoff for mild depression, their BID score is quite high (29) and indicative of clinically significant depression, and she reports a history of at least one depressive episode. She has sought help for emotional difficulties before, but only from her friends. She was born in the US and is a second generation Chinese-American, and does not feel that discrimination has negatively impacted her life. She lives with her parents. Her relationship with them in her childhood was less than ideal. She reports low Care and high Overprotection from her mother, and high Overprotection from her father. Her rating for her father's Care is right at the sample mean (26) and is therefore seen as neither high or low. She endorses Interdependent cultural values across all domains, and has few discrepancies between her beliefs and behaviors. She can therefore be described as very consistently and possibly even rigidly traditional, following the interdependent ideals of valuing community over personal independence.

Participant 404 shows a very different pattern. She is a 26 year old student pursuing a graduate degree. She has separated from her spouse and has no children. She emigrated to the US from Hong Kong as an infant. Although she endorses a few minor symptoms of depression (CDI score of 8, BDI score of 2), she shows no signs of significant depression and reports no history of depression. Her childhood relationship with her parents was also less than ideal. She reports low care and high Overprotection from both parents, a pattern usually associated with depression. Unlike participant 224, she endorses Independent cultural values across all domains. She is relatively consistent in applying these cultural beliefs, with few discrepancies between her beliefs and behaviors overall. Her acceptance of Independent beliefs and behaviors serve to protect her from low parental care, as will be discussed below.

Participant 519 also provides a clear contrast with the depressed participant, 224. She is a 40 year old professional with a high income and a graduate degree. She is married with no children, and lives with her husband. She emigrated to the US from Taiwan when she was 14 years old. She endorses relatively few symptoms of depression CDI score of 2, BDI score of 3) and reports no history of depression. Like participant 224, she reports low Care and high Overprotection from her mother; and moderate Care and high Overprotection from her father. She is also similar to participant 224 in her cultural values, which are largely interdependent. However,, her beliefs are Independent, and she is more independent in the work domain. Unlike any of the prior sample cases, participant 519 expressed greater than average discrepancies between her beliefs and her behaviors, across both family and social domains. These discrepancies may serve to give her the flexibility she needs to successfully cope with the parental Overprotection she recalls in her childhood. This effect will be discussed at length below.

Main findings: Parental bonds, Distress and Depression

This study failed to support the hypothesis that general distress explains the relationship observed by past researchers between the PBI and a broad array of psychological disorders. General distress showed weaker correlations with the PBI than any of the measures of depression. Further, the PBI scales were significant predictors of all three measures of depression when general distress was controlled for. They explained between 2.5 and 5.5% of the variance in depression scores, which is only slightly less than the variance explained in past studies that did not control for general distress (e.g. Martin & Waite, 1994, 6-8% variance explained). Participants' bonds with their mothers were better predictors of depression for all 3 measures (both for Care and Overprotection), likely because their mother was their primary parenting figure, so they would have had more experiences of her emotional nurturance or behavioral restrictions. The findings of this study support the conclusion of Zemore and Rinholm (1989) that depression has a unique relationship with parental bonds.

It is quite interesting to find that general distress did not account for the better part of the relationship between depression and parental bonds. It is not likely because of a floor effect in reports of either depression or generalized distress. As shown in Table 4.8, 30 (12.2%) participants endorsed significant depression on the CDI, 43 (17.5%) expressed significant depression on the BDI, 131 expressed a history of depression, and 14.6% reported significant distress. The means score for the BDI is within the ranges seen in non-clinical samples (Beck, Steer & Garbin, 1988), and the SCL-90-R responses are just above the normative T-score mean of 50. The DSM IV lists point prevalence of depression at 2-9% (American Psychiatric Association, 1994), so finding 12-17.5% at least sub-clinically depressed seems reasonable. This sample was reporting a reasonable level of symptomatology. The implications of these findings are very important to our understanding of parental bonds. A parental bond characterized by low Care and high Overprotection does not simply predispose one to experiencing more psychological symptoms in general; it predisposes one to experiencing depression, an organized and related subset of all the many symptoms we have come to see as signs of psychological distress. The findings of this study cannot rule out the possibility that the PBI may also predict the symptom sets of other disorders (such as anxiety) with equal specificity, but we know that at least in the case of depression, sub-optimal parental bonds predicts development of a syndrome, not just vague distress.

This study does not, however, indicate that there is not another mediating variable that links low care high overprotection bonds with depression, nor does it explain why so many disorders are often associated with the same pattern of PBI responses. In fact, it is likely that some such factor exists. It makes sense with the current research findings of connections between low care, high overprotection, and disorders as diverse as anxiety, schizophrenia, eating disorders and behavior disorders that some other factor would exist that explains which disorder would develop from sub-optimal parental bonds. Given the relationship between attachment theory and the PBI, it is possible that some outcome of the child's internal working model determines which syndrome will develop from these bonds. From early childhood experiences, the child develops a set of expectations for his or her world. This internal working model is similar to constructs in several schools of psychotherapy. It mirrors the Psychodynamic constructs of mental representations, and the Time Limited Dynamic concept of core maladaptive processes. It is also similar to the Cognitive Psychology description of automatic thoughts and core beliefs. The PBI has, in one study, shown a strong relationship with the presence of dysfunctional core beliefs (Shah & Waller, 2000). Perhaps parental bonds characterized by low Care and high Overprotection predispose a child to develop negative representations or beliefs about themselves, significant others, and the future. The exact nature of these core beliefs would then determine what type of psychopathology the child is more likely to experience in the future. This is only one possible hypothesis. Further research is needed to explore questions of this nature, using regression techniques similar to those employed in this study.

Main findings: Parental Bonds and Culture

This study attempted to show a connection between parental bonds and cultural constructs. Past research has simply applied the PBI to distinct cultural groups without any consideration of how the beliefs and behaviors of the new cultural group might related to the scales of the PBI. As parenting is a major means for the communication of culture, it logically follows that individual differences in cultural beliefs and behaviors should be related to parent-child relationships. In this study, participants who have adopted more western views reported less Care from both parents. This was particularly true for those with more western views of family life. Beliefs about family were also related to Overprotection, with independent subjects reporting more Overprotection from their mothers. Overall, Independence, especially in the family domain, was associated with less optimal parental bonds. This finding may reflect poorer parent-child relationships and higher conflict in families with a cultural generation gap (with children more independent than parents). Alternately, it may be part of a larger trend, in that low Care or attempts to overprotect may inspire people to be more independent, regardless of their culture of origin. Exploration of this effect in Caucasian samples will provide further information necessary to accurately interpret this finding. If it is shown to be unique to Chinese or Asian samples, the conflict/generation gap hypothesis should be accepted. If the same result is found in western samples, however, conclusions about independence in general can be drawn. Further research is vital to the interpretation of these results. Overall, this study did show that culture is an important factor in our perception of our bonds with our parents, and it needs to be taken into account in future studies of this nature.

This finding makes a great deal of sense from a cultural perspective. Participants who have maintained an interdependent stance will be judging their parents from a more eastern perspective, and will see different behaviors as reflecting Care or Overprotection. For example, they might interpret Care items such as “helped me as much as I needed” or “appeared to understand my problems and worries” (Parker et al, 1979, p 10) from a perspective of the family as the center of self, accepting that if their parents were working for the good of the family and solving family problems, the children's needs were also being met. Similarly, Overprotection items such as “let me decide things for myself” (Parker et al, 1979, p 10) could be read as only applying to things culturally appropriate for children to decide for themselves. Because of this, these interdependent participants would rate their interdependent parents as showing sufficient Care and reasonable protectiveness. Independent participants, however, would have adopted a more western definition of Care and Overprotection, and might judge their interdependent parents from this independent stance. Because of cultural constraints on the display of emotions, and the demands for conformity in interdependent family life, when judged from an interdependent stance these same behaviors will look particularly uncaring and sometimes overprotective. These conjectures again demonstrate the importance of considering cultural values when interpreting reports of parental actions.

Main findings: The interaction of culture and parental bonds: Care

Overall, main effects were found in this Chinese-American sample that replicate past research findings; low Care and high Overprotection lead to more symptoms of depression. However, this study showed that culture interacts with parental bonds in many ways, each of which provides a potential buffer between sub-optimal parental bonds and depression. The dimension of independence/interdependence was particularly related to parental Care. Participants who expressed greater personal independence, in any domain, were buffered from the negative effects of low Care. This is particular interesting to combine with the findings regarding culture and parenting alone. These same high-independence participants reported lower care from both parents. Due to this interaction however, it is unlikely that this low perceived care lead to greater depression for these participants. As with the previous finding on Independence, there are many possible interpretations that can be drawn. It could be that independence in general is a protective factor, allowing people to distance themselves from painful family relationships. Alternately, this finding could be particular to Chinese or Asian populations, and reflect that greater acculturation serves as a buffer between family relationships and depression. For instance, greater acculturation would likely allow an individual to draw on a wider array of social supports. Attempts to replicate this finding with Caucasian samples will again contribute greatly to the interpretation of these findings.

This result (protective function of independence) may also explain the conundrum seen in past research. Although Asian participants reported less Care than western participants, and lower Care was associated overall with greater depression in Asian samples, Asian population studies do not find higher rates of depression than seen in western populations. This may be because the participants most at risk for low Care (those who are highly independent) are protected from depression by their greater independence. Only those who are most likely to report a caring parental relationship are at increased risk for depression due to a lack of Care. To illustrate this, it is helpful to compare the case examples described above. Participant 224 and 404 are very similar. Both are roughly the same age and gender, and grew up in the United States. Both report difficult childhood bonds with their parents, characterized by low Care and high Overprotection. However, participant 224 is very likely depressed, with BDI score of 29, while participant 404 has only a few mild depressive symptoms (BDI of 2). The main difference between these 2 women is in their cultural values. Participant 224 has remained very traditional and interdependent, while participant 404 has adopted an Independent perspective. According to the interaction described here, this Independent stance is one main factor that protects participant 404 from becoming depressed, despite experiencing parental bonds characterized by low Care.

It is interesting to look at this pattern from a purely cultural perspective. The PBI is clearly a western measure of parenting. It was developed in Australia, and reflects logical outcomes of parenting aimed at nurturing children's independence. Because of this, one might expect that the construct of Care as defined by the PBI would be more relevant to those with a more western cultural identification. This was not the case, however, with the current research sample. This western construct of Care was only relevant to the outcome of depression for participants with more eastern cultural values. This leads the researcher to hypothesize that is is more likely to be a function of independence/interdependence in general that caused this pattern of results. If it were a culturally bound finding, one would have expected opposite results. The fact that eastern values are more associated with outcomes from a western ideal of parenting implies that there is something about interdependence itself that makes parental care important. When one is interdependent, one takes ones sense of self and esteem from the family and the larger culture. Independent people rely to a larger extent on their own notions of what is a positive accomplishment, and take personal credit for their accomplishments, while Interdependent people will rely on family feedback, and the feedback of other important social systems, for their interpretation of their accomplishments. This is a logical extension of the definitions on individualist and collectivist cultures provided by Triandis, McCusker and Hui (1990). From this theoretical perspective, it makes sense that interdependence in general (across cultures) would be important to the connection between family relationships and depression.

Main findings: The interaction of culture and parental bonds: Overprotection

A significant interaction was also found between discrepancies between beliefs and behaviors and parental Overprotection in predicting depression. Participants with greater discrepancy between their beliefs and behaviors were largely unaffected by parental Overprotection, while those with few discrepancies between their beliefs and behaviors were likely to experience depressive symptoms if either parent was Overprotective. This effect runs counter to the predictions of discrepancy theory. Higgins (1987) describes a strong relationship between the presence of discrepancies and development of psychopathology. Indeed, research on discrepancies within this same sample (Maxey, in press) shows that overall, greater discrepancies between beliefs and behaviors are associated with more depression and greater general distress. It is only when parental Overprotection is considered that discrepancies serve as a protection against depression. In this sense, discrepancies can be seen as a flexibility factor. Too many discrepancies or too much flexibility typically leads to distress, due to negative self-evaluations (Higgins, 1987). However, when ones parents are overprotective, and demand that their child conform to their way of thinking (e.g. PBI item # 9, “tried to control everything I did” or item # 15 “let me decide things for myself,”Parker et al, 1979. p 10), discrepancies help the child cope with these demands. They can conform to parental demands while forming their own ideas of what behaviors to take. They can be flexible in applying behaviors across different situations, and in later life will not always be guided by the rigid ideals of their parents. This presents a hypothesis that needs to be tested with further research. It needs to be determined if there is indeed a relationship between discrepancies and flexibility or rigidity, and if there is a connection between being an overprotective parent and rigidity.

Two of the case studies described above give examples of this interaction at work. The depressed case, 224, also shares a great deal in common with participant 519. Although they are of different ages and different immigration histories (factors not correlated with depression in this sample), they have similar views of their parents. Both reported low Care from their mothers, moderate Care from their fathers, and high Overprotection from both parents. Both are also relatively traditional in their cultural behaviors, with total CBBAP scores falling below the mean for independence. However, participant 224 reports few discrepancies between her beliefs and her behaviors. As described above, she is probably moderately depressed, with a BDI score of 29. In contrast, participant 519 reports many discrepancies between her beliefs and behaviors. In particular, she believes her actions should be more independent that she reports them to be, enough so that her CBBAP Belief score is in the Independent range. These discrepancies between her beliefs and her behaviors may help her to maintain flexibility when interacting with her Overprotective parents.

Main findings: Fathers and the dominant influence of Care

The interaction above was not shown consistently for fathers. For fathers, but not for mothers, a 3 way interaction was observed, indicating that when fathers showed low Care, all participants were equally likely to report depressive symptoms, regardless of the level of paternal Overprotection they report or the amount of discrepancies they reported between their cultural beliefs and behaviors. This indicates that there is something dominant about the role of fathers' Care – it washes out the effects of other important variables in this study. This is somewhat consistent with past research. Of the 5 studies that report differences in correlations between each PBI scale and level of depression, all list father's Care as one of the primary factors, and 2 report fathers Care to be significantly more correlated with depression than all other PBI variables (Howard, 1981; Martin & Waite, 1994). Both of these studies were conducted with groups of adolescents in Australia. Each showed that fathers' Care was the strongest predictor of adolescent depression, with mother's Overprotection the only additional significant predictor.

From these studies, it can be concluded that low paternal Care is particularly important in adolescence - years critical for identity development. This may indicate that fathers play a crucial role for children developing an identity as a capable and lovable individual. Fathers are typically not the primary caregiver, but are instead seen as the traditional financial support of the family. Perhaps children look to fathers for an example of what it takes to succeed in the world. A father's affection and approval would then play a unique role in a child's sense of whether they themselves will succeed in the world outside the family. In the current study, fathers' Care did not by itself show a stronger relationship with depression than other PBI scales, nor did it play a primary role in any other adult samples (see Table 1.1). However, it was the only PBI scale that was independently related to depression. If fathers showed low Care, participants in this study were more prone to depression, regardless of fathers' overprotection. This may indicate that fathers' Care retains much of its dominant role beyond adolescent years. Low care from fathers in particular may be bound into a child's identity, and when that care was absent, even if fathers encouraged independence, individuals are more prone to feel inadequate and depressed.

Unexpected results

Overall, the results discussed above add a great deal to our understanding of parental bonds, by revealing several surprising trends. It has long been thought that, from adolescence on, ones perception of parental bonds is relatively consistent. This study disconfirms that belief, showing that older adults see their parents as more caring and their mothers as less overprotective than younger adults. If one accepts this cross-sectional finding as accurate, it might suggest that this shift is more consistent with the reports of younger children (Rey et al., 1993) and with parent self-reports (Parker, 1981a), and may reflect a more accurate or balanced understanding of parental actions due to a broader range of life experiences, including experiences of caretaking and personal responsibility. This study also found that, despite being related to a wide array of symptoms and syndromes, dysfunctional parental bonds predispose for depression itself, not just for adverse symptomatology in general. Finally, this study showed that culture plays an integral role in determining how parental bonds will affect a child, although not in the ways that would be expected. Interdependent participants, but not westernized or independent participants, showed the typical relationship between low Care and depression, despite the fact that a western conceptualization of Care was used. This may indicate that individual differences in Interdependence themselves may be important to consider in conjunction with parental bonds, even in western samples. The determining factor here may not be one of Chinese vs American culture, but of an individual's sense of connectedness with and dependence on others. Further, greater discrepancies between beliefs and behaviors, when considered together with parental Overprotection, served as a protective factor, not as a risk factor. This may be because they add a level of flexibility in the behaviors of a child exposed to rigid parental ideals.

Limitations and needs for future research

This study has several limitations that affect how the findings should be applied and understood. First, the research sample in this study consisted of a rather unique group of Chinese Americans. Living predominantly in California's Bay Area, these participants were of relatively average income, and were part of a large and socially active minority. The area is also seen by this author as being more culturally sensitive than many metropolitan areas. Therefore, the participants in this study may not have experienced as many of the stressors that immigration often entails. Because of this, caution should be used in generalizing the results of this study, even to Chinese-Americans in general, as the acculturation experiences of those living in other communities is likely to have been quite different. In order to be relied upon, these results need replication in other Chinese-American and Asian-American communities.

Results reflecting trends in parental bonding in general are likewise not necessarily generalizable to all parents and children, as the sample was limited to such a unique population. They need replication in a broader, more representative sample. This necessary replication can be carried out at the same time as major questions in this research are clarified. Because no Caucasian participants were included, it is unclear if the cultural findings apply to independence/interdependence in general, or if they are restricted to Chinese-Americans. A diverse sample that is representative of the population as a whole would allow for cross-cultural comparisons of these effects while allowing the generalizability of the main findings to be determined.

Also, the sample used in this study was a community sample. It is unknown whether any participants currently met diagnostic criteria for depression or any other disorder, or whether they were in treatment or not. Results may have limited generalizability to clinical populations, which are likely experiencing a much greater severity of symptoms than was seen in this sample.

This study is further limited by the methods used in assessing depression, culture, and parental bonds. All of the measures used int his study were self-report, and are therefore liable to be biased by the response style of participants. As has been shown in research with the PBI and the Adult attachment interview, the main failing of the PBI as a measure of attachment related constructs is that it provides no control for participant idealization of sub-optimal parenting, or participant anger towards adequate parents. Several factors unrelated to interactions in infancy were likely to have influenced participants' reports, including a mismatch between parent discipline and child temperament later in childhood and adolescence, disruptive life events such as divorce or death of a parent, and factors related to immigration and acculturation. The PBI does not provide information necessary for making attachment classifications. It merely describes the participants' current perceptions of their parents, and is therefore subject to any biases the participant may have. This may in fact make the findings easier for therapists to apply in their work. Therapists will not need to play detective and determine the accuracy of their clients' reports of parental bonds. If a client believes their mother was uncaring, then the findings regrading low maternal Care will apply for that client.

Likewise, measures of depression and distress in this study were self-report. No diagnosis or confirmation of participant ratings was carried out by any clinician. Although the measures involved have shown high correlations with observed symptoms of depression and distress (Beck, Rush, Shaw & Emery, 1979; Derogatis, 1992; Zheng & Lin, 1991), participants may have either under- or over-reported their level of symptomatology. Also, it is unclear whether any participants would have met diagnostic criteria for depression or any other disorder. Consequently, results should be understood as related to depressive symptoms, and may not be generalizable to Major Depressive Disorder itself.

The instrument chosen to measure generalized distress also has some weaknesses. The SCL-90-R (Derogatis, 1992) measures distress in terms of psychological symptoms that are part of the symptom set one of several diagnoses. However, not all forms of distress are listed as diagnostic criteria. In particular, milder forms of distress may be missed by this instrument. The SCL-90-R General Distress scale can best be understood as a tendency to report a variety of significant psychological symptoms. It does not capture all aspects of human distress. This must be kept in mind when examining the direct relationship found between depression and parental bonds. Depression in this study was only shown to have a direct relationship with parental bonds when the tendency to report significant symptoms was controlled for.

Similar limitations apply to the measures of culture used in this study. The behaviors and beliefs on the CBBAP have been shown to correlate with other measures of culture and Asian identity (Gartstein, Shiang & Bogumill, 2000), but have not been compared to actual observations of behaviors. This is particularly relevant for participant rating of behaviors, and for measures of discrepancy. We have no knowledge of how accurately participants tend to rate their actual behaviors on this measure. Participants may have adopted a modest style and reported less desirable behaviors than they actually perform, or may alternately responded in what they saw as a socially desirable way.

These limitations do not negate the results of this study. Although measures were self-report, they all have demonstrated reasonable construct and predictive validity. Therefore, the need to interpret these results with caution is no greater than would apply to the results of any study of similar design. Likewise, the problems in generalizability of the results of this study would likely apply to any similar study in the field of culture and parent-child relationships. Each sample is unique in several important ways. Results should be interpreted with a reasonable level of caution, and, as is the case with any research, need replication to establish them as reliable and generalizable observations of human behavior.

Clinical Implications

This study has several important implications, particularly for improving cultural sensitivity in therapists working with minority clients, particularly Asian or Chinese Americans. Overall, this study showed the importance of individual differences within a cultural group and across social settings. It is not enough to know about Chinese culture to be culturally sensitive with a Chinese-American client. Rather, therapists need to understand each individual's acceptance of cultural demands across a variety of settings. Therapists should understand that the family domain pulls for the most traditional behaviors, and that Chinese Americans overall feel that they should be more traditional at home than they are able to be. This could be a source of guilt or conflict for the individual in therapy that could be missed if a therapist were to treat culture as a single entity. Furthermore, individual differences in acculturation are particularly salient for mental health. Not all Chinese-American participants showed the same connection between parental bonds and depression. Individual differences in cultural beliefs and behaviors determined which participants were more likely to suffer adverse psychological events in response to parental Care and Overprotection. In particular, parental Care was not related to depression in clients who were more independent. These clients were also more likely to report low Care in general. It would be counterproductive, therefore, to focus heavily on family relationships in treating a more independently minded depressed Chinese American, whereas these relationships might be central to the treatment for a more interdependent client. Without knowing a client's stance on their own culture, therapists will be unable to choose the most appropriate focus for treatment.

Clinicians should also be aware of the findings in this study regarding discrepancies between cultural beliefs and behaviors. Most literature points to the conclusion that discrepancies between beliefs and behaviors have a negative impact on mental health (Higgins, 1987). However, this study showed that to not always be the case. At least in regards to cultural beliefs and behaviors, the ability to behave inconsistently with one's beliefs proved to be a buffer between parental Overprotection and depressive symptoms. This appeared to be true regardless of the direction of the difference. Overprotective parents are describe by items that imply rigidity and attempts to control. Discrepancies between beliefs and behaviors may allow clients to internalize the actions and statements of their parents without losing personal flexibility in their own actions. They can avoid being dragged into a cycle of arguments and conflict while maintaining a sense of themselves as a distinct individual. Therapists should be aware of this, particularly if they hold to an orientation that tends to confront client “should” statements. They should be careful to assess what role this discrepancy is playing for the client. Is the difference between what a client believes they should be doing and what they are doing causing them to feel inadequate and depressed, or is it helping them interact effectively with significant others who hold rigid beliefs and desire control in relationships? In the first case, confronting these beliefs would be helpful for the recovery of the client. In the second case, confronting these beliefs may be destructive to the social support systems and coping strategies of the client.

Finally, this study showed that parent-child relationships are likely to be uniquely relevant for clients who display depressive symptoms. When working with such clients, therapists should be careful to assess for family dynamics, and understand the role they play in maintaining the depression. Attachment theory predicts that these early relationships will be integrated into a person's worldview, and this study showed that these relationships predict depression in particular. Parental bonds characterized by low Care and high Overprotection share a direct relationship with the development of depressive symptoms. Therefore, it is much more likely that any successful therapy for depression will need to address constructs related to care and overprotection. This does not have to be carried out from a psychodynamic perspective. For example, a cognitive therapist could assess for automatic thoughts and core beliefs around concepts related to parental Care and Overprotection, such as beliefs about one's worthiness for love, or one's ability to succeed when acting independently. Changing these beliefs would be important for recovery from depression, and coping skills around assertiveness and recognizing or accepting care from others would be important for preventing relapse in response to future life stressors. Clearly, these dynamics will not be relevant for all depressed clients. Indeed, the relationship between Care and depression was not seen in independent clients in this sample. These findings do, however, show that these factors are likely to be interrelated, and suggest an important point for consideration in assessment and treatment planning.

Summary and Conclusions

Culture, parent-child relationships, and depression are all interrelated in a complex fashion that demands sensitivity and careful assessment on the part of therapists. Culture was shown in this study to be a multi-dimensional construct, with different values seen in different domains. Beliefs regarding how one should act in a situation were also shown to be different from actual behaviors in that situation. When taken alone, parental bonds were shown to have a direct relationship with depressive symptoms. However, cultural values in part determine whether or not this connection will be played out for any given individual. Cultural values were related to perception of parenting, and to the connection between parental bonds and depression. Particularly, while greater independence is associated with less perception of Care from parents, it also serves as a protective factor from the negative effects of low Care. Past research showing that certain groups report lower Care may be affected by this finding – low Care is not always relevant to any given individual. This research strongly emphasizes the need for sensitivity to cultural differences on the part of both researchers and therapists. Both are likely to be lead in the wrong direction if they do not account for the individual differences in cultural beliefs and behaviors.

Parental bonds do not exist in a vacuum. Parents choose their actions based on their own cultural and value systems, and children interpret these reactions based on their own perspective on the same culture. Children raised in a multicultural environment are able to thus acquire flexibility and perspective that can protect them from negative outcomes. They may, for example, come to recognize that their parents did not show them the Care they wished because of cultural differences, and consequently be less effected by this lack. They can learn to hold conflicting beliefs and behaviors to allow themselves to cope with rigid demands in the family setting. Cultural beliefs are more than just a backdrop for parent-child relationships. They shape the relationship and they shape the path of potential outcomes. Culture is an active player in the family system. Only when we understand the interactions between these factors can we fully understand the role that parent-child bonds play in determining adult psychopathology.

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