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Long-Term Sequelae of Emotional Parentification: A Cross-Validation Study Using Sequences of Regressions

Authors:
  • Martin-Luther-University Halle-Wittenberg
  • Psychiatrische Klinik Sanatorium Kilchberg, Zürich

Abstract and Figures

The aim of our study was the analysis of longterm sequelae of emotional parentification in childhood. Two samples (n = 500 each) were examined via the internet regarding parentification and perceived love in childhood, as well as other childhood experiences such as abuse, having been raised by a single parent and parental loss, as well as adult depressive and vegetative symptomsand pain. A questionnaire set containing 280 items was filled out. Emotional parentification in childhood, maternal as well as paternal, was found to be a strong predictor of depression in adulthood. Indicators of somatization showed associations in the same direction, but these were much weaker. Also, associations between paternal parentification and vegetative symptoms, as well as between maternal parentification and pain in adulthood could be observed. Perceived love from the father during childhood was one of the protective factors for development of various problems in adult life. The results indicate the necessity of directing more attention, both clinically and empirically, towards emotional parentification.
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1 23
Journal of Child and Family Studies
ISSN 1062-1024
Volume 24
Number 5
J Child Fam Stud (2015) 24:1307-1321
DOI 10.1007/s10826-014-9938-z
Long-Term Sequelae of Emotional
Parentification: A Cross-Validation Study
Using Sequences of Regressions
Katarzyna Schier, Max Herke, Ralf
Nickel, Ulrich T.Egle & Jochen Hardt
1 23
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ORIGINAL PAPER
Long-Term Sequelae of Emotional Parentification: A Cross-
Validation Study Using Sequences of Regressions
Katarzyna Schier
Max Herke
Ralf Nickel
Ulrich T. Egle
Jochen Hardt
Published online: 9 March 2014
Springer Science+Business Media New York 2014
Abstract The aim of our study was the analysis of long-
term sequelae of emotional parentification in childhood.
Two samples (n = 500 each) were examined via the
internet regarding parentification and perceived love in
childhood, as well as other childhood experiences such as
abuse, having been raised by a single parent and parental
loss, as well as adult depressive and vegetative symptoms
and pain. A questionnaire set containing 280 items was
filled out. Emotional parentification in childhood, maternal
as well as paternal, was found to be a strong predictor of
depression in adulthood. Indicators of somatization showed
associations in the same direction, but these were much
weaker. Also, associations between paternal parentification
and vegetative symptoms, as well as between maternal
parentification and pain in adulthood could be observed.
Perceived love from the father during childhood was one of
the protective factors for development of various problems
in adult life. The results indicate the necessity of directing
more attention, both clinically and empirically, towards
emotional parentification.
Keywords Adult depression Parent–child relationships
parentification Childhood traumatic experiences Internet
survey
Introduction
Parentification means that a child takes care of his or her
parent. In terms of attachment theory (Bowlby 1969), it
could be said that in order to ‘survive emotionally’’,
children have to mobilize their caregiving system towards
the parents, instead of receiving care from them (Schier
2009). Their own attachment needs to remain in the
background because this is the only way they are able to
maintain proximity to their parent. Parentification tends to
take place at school age rather than in infancy (e.g. Macfie
et al. 2008), but as with attachment styles, lifelong and
even some transgenerational stability can be expected (e.g.
Macfie et al. 2005). The results of transgenerational
research provide some evidence that these parents either
did not develop a safe attachment pattern in their rela-
tionships with their own caregivers or they have a history
of unresolved traumatic experience. Solomon and George
(1999) describe mothers with disorganized attachment
patterns as individuals who are not able to regulate their
own emotions; therefore they cannot help their children in
their process of self-regulation. Children are used by such
parents in their own process of affect regulation; in this
generational distortion of the boundaries, these children
function as self-objects (psychological part) of the parents
(Wells and Jones 1998). Research results show that even
very small children can function as self-objects. Fivaz-
Depeursinge and Favez (2006) show that babies as young
as 8 months can feel tension between their parents and are
able to modify it through their protest or provocation.
K. Schier
Faculty of Psychology, University of Warsaw, Warsaw, Poland
M. Herke J. Hardt (&)
Medical Psychology and Medical Sociology, Clinic for
Psychosomatic Medicine and Psychotherapy,
Universita
¨
tsmedizin, Johannes Gutenberg University, Mainz,
Germany
e-mail: jochen.hardt@gmx.de
R. Nickel
Clinic for Psychosomatic Medicine and Psychotherapy, HSK
Wiesbaden, Schlangenbad, Germany
U. T. Egle
Clinic Kinzigtal, Gengenbach, Germany
123
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DOI 10.1007/s10826-014-9938-z
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Researchers (Cassidy et al. 1998; Jacobvitz et al. 1999)
assume that children between the fifth and seventh year use
two different strategies to cope with parentification in their
family. They are either controlling and caring or control-
ling and punitive towards their caregivers. They develop
these strategies to cope with the helplessness of their par-
ents, which can include both the caregivers’ (mostly
mothers’) fear for their children and/or the fear of their own
loss of control (Jacobvitz et al. 1999).
In family therapy, parentification has found attention in
various systematic views (e.g. Boszormenyi-Nagy and
Spark 1981; Minuchin et al. 1981; Richter 1963). Parenti-
fied children either fulfill instrumental caretaking roles
within the family system, such as caring for younger sib-
lings, working to earn money or housekeeping, and/or they
may play emotional caregiving roles in providing advice,
comfort or protection to family members, replacing a
missing partner (sometimes even sexually), etc. (Fitzgerald
et al. 2008; Guziak 2010; Jurkovic 1997). The term ‘par-
entification’ was coined by Boszormenyi-Nagy and Spark
(1981) to describe not only a form of family dysfunction but
also a form of family life in general. Therefore, a distinction
should be made between ‘‘constructive parentification’’ (i.e.
a child’s adequate contribution to the family) and
‘destructive parentification’ (i.e. an inadequate contribu-
tion compromising the development of the child, both in the
short and long term). Destructive parentification develops
through the process of role induction in that caretakers
prematurely demand independence from their children,
display helplessness or request that their children behave
like adults (Jurkovic 1997). According to Jurkovic (1997),
the following components of parentification are to be con-
sidered: (1) overtness, (2) type of role assignments, (3)
extent of responsibility, (4) object of caretaking, (5) age
appropriateness, (6) degree of internalization, (7) family
boundaries, (8) social legitimacy and, (9) ethicality. The
first element especially is of vital importance. The more
covert the process of parentification in the family is, the
greater the psychological burden on the child. In such a
situation, the child may often not be able to realize that its
role in the family is unfair (Jurkovic 1997; Schier 2009).
In some circumstances, a child has to fulfill the role of
an adult, but the reason is obvious, the child’s status is not
concealed and other family members are grateful. An
example could be immigrant families in which the child
conducts paperwork for his or her parents (Jurkovic 1997;
Jurkovic et al. 2004). Of course, immigrant families face a
variety of difficulties in a foreign country but if the situa-
tion of the ‘‘child as a carer’’ (Aldridge and Becker 1993)is
temporary and has a justification, then the child does not
necessarily suffer from any negative consequences.
Nevertheless, psychologists (mostly psychotherapists)
have reported cases of extremely destructive parentification.
An important question arises here: why does a parent look to
his or her child for support, either instrumental, emotional, or
both? Jacobvitz et al. (1999) believe that only those adults turn
to their children to fulfill parental roles who consider their
unmet needs for nurturance in childhood as ‘accounts due’
and look to their children for parenting as a way of balancing
the ledger. A particularly critical situation is sometimes found
in children of alcoholics (Guziak 2010). These children may
perceive their parent’s disorder but feel desperately alone with
other aspects, e.g. when sexual contact forced on the child by
the father is tolerated by the mother (Beisert 2004). Generally
when discussing sexual abuse, we are in line with authors who
consider sexual abuse within the family as a form of paren-
tification, e.g. Jurkovic (1997) or Chase (1999). If the child is
fulfilling the sexual needs of an adult, the situation has the
status of parentification.
Parentification in families is considered a trauma by
some authors. According to Hooper (2007), parentification
involves three of the four characteristics of trauma as
defined by Tadeschi and Calhoun (1995). These are: (1)
traumatic events are usually sudden and unexpected, the
person confronted with them is unprepared (2) a traumatic
event or environment leaves an individual feeling like he or
she has no control, (3) trauma is often an unknown event,
so that a person does not know how to cope with it and (4)
traumatic events lead to long-lasting consequences for an
individual’s ability to function. Hooper (2007) points out:
‘First, parentification often leaves the child feeling like he
or she has no control over the traumatic situation. Second,
when the child first experiences parentification—depending
upon age, maturity level, and developmental stage—he or
she often feels ill-equipped to carry out a parental role in
the family. Third, the empirical literature has supported the
finding that parentification can and often does lead to long-
lasting problems in adult functioning’ (p. 329). Hooper
(2007) also compares parentification with neglect: it is a
situation in which a child sacrifices his or her own needs
for attention and comfort in order to care for the logistical
and emotional needs of a parent and/or sibling. Jurkovic
(1997) describes pathological parentification as ‘a dis-
criminable category of maltreatment’’. Zeanah et al. (1993)
classify it as a ‘‘role-reversed attachment disorder’’. Taking
this into consideration, the investigation of the conse-
quences of parentification, both psychological and physi-
cal, is crucial.
Children taking care of their parents develop a ‘false ego’
as it is described in psychodynamic theories: an internal
structure that helps them to cope with their burden (Guziak
2010; Schier 2009). This structure can be reinforced by the
parentifying parent; these children may be told that they are
‘brave and strong’’. This, in turn, hinders the developmental
process of separation-individuation. Finally, children lack a
secure notion of who they are; Schier (2005) and Guziak
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(2010) suggest that they often experience themselves as
invisible. According to Leon and Rudy (2005), these chil-
dren have developed a representation of themselves as a
caregiver and of the parent as a recipient of care. ‘This set of
mentalized expectations about relationships may be gen-
eralized to other relationships, resulting in unbalanced peer
relationships, in which the child plays a caregiving and/or
controlling role’ (Leon and Rudy 2005, p.113). Some
authors (Wells and Jones 1998) think that the failure to
separate from their parents may leave parentified children
vulnerable to the use of a dissociative defense mechanism,
defined here as keeping apart opposing psychological rep-
resentations (e.g. positive and negative images and feelings
toward self and others). This defense mechanism allows
them to preserve the ‘good’ internal representation of the
caregiver despite their difficult experiences. However, the
utilization of this defense mechanism has consequences for
their way of functioning in social relationships. Suppressed
anger and lack of affect regulation strategies may cause a
state of chronic tension. Another possible consequence of
attempting to fulfill a caring role that it is not possible for a
child to fill adequately is the development of self-blame and
guilt feelings (Byng-Hall 2002). In the long term, either
somatization or depression can be the result (Schier 2005,
2010). Many authors point out that parentified children often
suffer from depression, suicidal feelings, shame, excessive
guilt, social isolation, psychosomatic problems and other
internalizing and/or externalizing symptoms both during
childhood and later as adults (Byng-Hall 2002; Jurkovic
1997; Wells and Jones 1998).
Our goal was to investigate the possible consequences of
emotional parentification. These are depression or somati-
zation (the latter represented by vegetative symptoms or
pain) in adulthood. Additional possible antecedents, such
as being raised by a single parent, long-term absence of a
parent or sexual abuse were considered. Furthermore,
associations between parentification and perceived love
from both parents were taken into consideration. Previous
studies on parentification generally show the possibility of
an interaction between various risk factors in understand-
ing the sequelae of parentification (Jurkovic 1997); (Hardt
2004a; Jurkovic et al. 2001). However, the results of the
studies are partly inconsistent, which induced us to perform
this study.
Method
Participants
The present analysis is based on two internet surveys of
about 500 subjects each. They were carried out in 2008
within an interval of almost a year. Via e-mail, respondents
were asked to fill out a set of questionnaires containing
about 280 items. The set consisted of questions about their
current mental and physical condition as well as a variety
of childhood experiences. Respondents were informed that
the survey was for research purposes and that the
researchers were interested in mental health and various
circumstances of life. Participants received compensation
of about 430 for answering the questionnaire, which took
about half an hour. The ethics commissions of the Uni-
versity of Du
¨
sseldorf (2873) and the Landesa
¨
rztekammer
Rheinland-Pfalz approved the project (837.185.07). Data
collection was performed by a commercial company that
mainly performs marketing research (http://www.linequest.
de). Participants of the extraction sample were 50 %
female and 50 % male, in the cross validation sample 55 %
female versus 45 % male. Mean ages were 45 and 39 years
for the extraction and cross validation samples, respec-
tively. More detailed sample descriptions are provided in
Table 1.
Measures
Three variables were chosen as primary responses—one
indicating depression, two indicating somatization, i.e.
vegetative symptoms and pain. All three were assessed
using the SCL-27-plus (Hardt 2011), a questionnaire
designed to screen for mental health complaints in adults.
The SCL-27-plus assesses five dimensions in terms of
current symptoms, i.e. how often the symptoms were
present in the previous 2 weeks. The subjects had to choose
between five possible answers, ranging from ‘never’ to
‘very often’ (Hardt 2011). Depressive symptoms were as
follows: ‘melancholy’’, ‘feeling blank inside’’, ‘would
rather be dead’ ‘hopelessness’ and ‘loss of joy’’. The
vegetative symptoms were assessed on a scale with the
following items: ‘dizziness’’, ‘nausea’’, ‘heart palpita-
tions’’, ‘heart pounding’ and ‘stomach troubles’’. Pain
was assessed with items such as: ‘headaches’’, ‘chest
pains’’, ‘muscle cramps’’, ‘muscle pain/sore muscles’’,
‘pain in arms and legs’ and ‘backaches’’.
Parentification and parental love were assessed using the
Childhood Questionnaire (CQ: Hardt, Dragan, Schultz, and
Engfer 2011; Hardt, Fischbeck, and Engfer 2011), an
instrument originally developed to assess the dimensions
that were evaluated in the Adult Attachment Interview
(George et al. 1985). Subjects were asked to describe their
relationship with their mothers and fathers during their first
14 years of life. The scale assessing parentification con-
cerned only ‘emotional parentification’ with items such
as: ‘When my parents had marital troubles, I was always
supposed to defend my mother’ or ‘‘I often felt responsible
for my mother’’. The scale ‘love’ consisted of items such
as ‘my mother was always there when I needed her’ or ‘I
J Child Fam Stud (2015) 24:1307–1321 1309
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did not get real love from my mother’ (inverted). Items for
mother and father were phrased identically. Both ques-
tionnaires, the SCL-27-plus and the CQ, can be viewed at
www.screening4you.de.
Three variables concerning childhood sexual abuse,
longer absence of a parent and growing up with a single
parent were included in the present analysis. Sexual abuse
was defined as any unwanted sexual experience before the
age of 15 that was (a) considered as abuse by the subject,
where (b) a person was involved who was at least 5 years
older than the subject, and (c) which involved intercourse or
at least mutual touching of sexual organs. Longer absence
was defined as one parent being absent for 6 months or
longer. In most cases, it was the father. These two variables
as well as the information about growing up with a single
parent were assessed by a self-rating form from the Mainz
Structured Biographical Interview (Egle and Hardt 2004).
Age and sex were added as demographics. The nationalities
of the samples were 97 % German in the extraction sample
and 94 % German in the cross-validation sample. Table 1
displays the descriptive statistics of the samples.
Statistics
For one subsample, ordered sequences of regressions were
constructed as described below. The second subsample was
used for cross-validation. Sequences of regressions are an
extension of path analysis (Wright 1934); they are used to
test for moderators and mediators simultaneously (Baron
and Kenny 1986). In addition to path analysis, sequences of
regressions can contain binary variables as responses and
tests for nonlinear associations. This is the reason why
ordered sequences of regressions were chosen for the
present analysis instead of Structural Equation Modeling
(SEM: Jo
¨
reskog and So
¨
rbom 1984). In its original
formulation, SEM did not include both binary variables and
tests for nonlinear associations, and currently it still has
some unsolved problems when both are included.
Sequences of regressions were specifically developed to
test both, and first explored analyzing life science data.
Sequences of regressions allow the formulation of directed
and undirected effects (Wermuth 2003). They are not
identical to, but generalize Markov chains (Markow 1971).
They become identical to SEM if the variables have a joint
Gaussian distribution (Wermuth and Cox 2013).
In constructing the sequences of regressions, variables
were grouped into blocks (see Fig. 1), and then significant
explanatory variables were selected for each response (Cox
and Wermuth 1996). Therefore, all variables in a block to
the right of a certain variable in Fig. 1 were tested as
possible predictors for this variable. To test this, first a
model containing all relevant main and quadratic effects
was chosen. Within this model, all two-way interactions
were tested. Interactive terms were kept in the model if
there was an additional significant joint contribution of this
variable pair. The joint effect was tested using a X
2
-or
F-test with two degrees of freedom (df) for a squared term
and three df for an interaction term. The significance level
for generating the model was set to a = .01 (two-sided).
The results obtained with this procedure are displayed in
the left-hand columns of Tables 2 and 3. Often, sequences
of regressions are shown additionally including the asso-
ciations of variable pairs within each block (see Cox and
Wermuth 1996). As we already report many associations
here and since only the directed associations are needed to
track development over time, they have been omitted here.
The model extracted was then cross-validated on a second
sample. Each significant coefficient from the extraction
sample was tested in the cross-validation sample to verify its
significant difference from zero in the same direction as in the
Table 1 Variable description
Block Variable Description Possible
values
Min Max Extraction sample Cross-validation
Mean SD Mean SD
1 DEP Depressive symptoms 0–4 0 4 0.73 0.82 1.09 0.99
1 VEG Vegetative symptoms 0–4 0 4 0.91 0.65 1.14 0.67
1 PAIN Pain 0–4 0 4 1.40 0.76 1.66 0.65
2 PAR_M Maternal parentification 0–3 0 3 0.74 0.93 0.92 0.96
2 PAR_P Paternal parentification 0–3 0 3 0.41 0.54 0.46 0.54
2 LOV_M Maternal love 0–3 0 3 2.18 0.80 1.95 0.90
2 LOV_P Paternal love 0–3 0 3 1.74 0.64 1.59 0.72
3 SEX_AB Sexual abuse 0, 1 0 1 8 % 0.27 13 % 0.34
3 SINGL Single parent 0, 1 0 1 7 % 0.25 7.4 % 0.26
3 ABS Longer absence of a parent 0, 1 0 1 24 % 0.43 24 % 0.42
4 GEN Gender (male) 0, 1 0 1 50 % 0.50 45 % 0.50
4 AGE Age C18 18 81 44.8 16.1 39.3 11.2
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extraction sample. Only coefficients that fulfilled this condi-
tion were retained. No further tests to add variables were
performed at this stage. The significance level for the cross-
validation was set to a = .01 (one sided). Results obtained in
the cross-validation are displayed in the right-hand columns of
Tables 2 and 3. If a variable/term was cross-validated, it has
all coefficients displayed plus a t value in the second last
column (columns titled ‘‘cross validation sample’’). If a var-
iable could not be cross-validated, no coefficients but only a
t-value in the last column is displayed, indicating the value if
this variable/term would be added next to the model (column
titled ‘‘excluded variables’’). This is a conservative selection
of effects, i.e. the alpha level ensures that we obtain significant
effects, but it is not likely that all effects are detected. Analyses
were performed using R (R Development Core Team 2011).
The final effects are shown in Figs. 1 and 2; they are
based on data from the cross-validation sample only. Fig-
ure 1 gives an overview of the significant associations in
the model; all arrows in the figure indicate significant
associations. For easier readability, Fig. 1 has been subdi-
vided into five separate aspects to avoid overlapping of
arrows; one may imagine that all figures are layered on top
of one another in order to comprehend the model. Figure 2
displays the types and strengths of the relationships. The
latter were derived by graphing the conditional effect of the
respective variable(s) when all others were kept in the
regression model, i.e. by using the regression formulae.
The X-axes of the graphs display the full theoretical range
of the respective scales; the curves are drawn only for the
middle 90 % of the observed distributions in this sample in
order to avoid over-interpretation in cases of nonlinearities.
Results
Primary Responses
Depressive Symptoms
The first primary response, depressive symptoms, had four
significant direct predictors that could be cross-validated:
paternal love, maternal and paternal parentification, and the
longer absence of a parent. Beyond that, paternal love and
absence of a parent showed an interaction (Table 2).
Maternal and paternal emotional parentification were
both linearly associated with depressive symptoms
(b
parentification_mother
= 0.40, t = 5.90, p \ 0.001 and
b
parentification_father
= 0.31, t = 3.27, p \ 0.001; Fig. 1a, b);
the more a child was parentified by either parent during
childhood, the more depressive symptoms were reported in
adulthood. The interactive effect of paternal love and the
Pain
Depressive
Symptoms
Love
Love
Age
Sexual
abuse
Gender
Parenti-
fication
Single
Parent
Mother
Father
Vegetative
Symptoms
Long-term
Absence
Depressive
Symptoms
Mother
Father
Single
Parent
Age
Gender
Sexual
Abuse
Abuse
Abuse
Long-term
Absence
Parenti-
fication
Vegetative
Symptoms
Pain
Depressive
Symptoms
Vegetative
Symptoms
Pain
Mother
Father
Love
Parenti-
fication
Single
Parent
Long-term
Absence
Sexual
Age
Gender
Depressive
Symptoms
Vegetative
Symptoms
Pain
Mother
Father
Love
Parenti-
fication
Single
Parent
Sexual
abuse
Long-term
Absence
Age
Gender
Depressive
Symptoms
Vegetative
Symptoms
Pain
Mother
Father
Love
Parenti-
fication
Single
Parent
Sexual
Long-term
Absence
Age
Gender
Fig. 1 Overview of significant associations among the variables
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longer absence of a parent on depressive symptoms iden-
tified paternal love as a protective factor generally, but the
effect is significantly stronger when there is no long absence
of a parent in childhood (Fig. 1c). These four predictors
together explain about 26 % of the variance in the
depression scale. In the extraction sample, maternal love
also demonstrated a significant interaction with paternal
parentification. In addition, there were linear effects of
being raised by a single parent and by gender. None of the
latter four maintained significance in the cross-validation
(see Table 2, right column, ‘excluded variables’’).
Vegetative Symptoms
For the second primary response, vegetative symptoms, four
significant predictors remained significant after cross-valida-
tion, but no interactions (Table 2). Maternal love was associated
with high reports of vegetative symptoms (b
love_mother
=
0.07, t = 1.98, p \ 0.05; Fig. 2d), as was paternal paren-
tification (b
parentification_father
= 0.31, t = 5.41, p \ 0.001;
Fig. 2f), whereas paternal love (b
love_father
=-0.13, t =-3.69,
p \ 0.001; Fig. 2e) and being of male gender (b
gender
=
-0.25, t =-4.25, p \ 0.001; Fig. 2g) were protective
factors. An interaction of maternal love with the long absence
of one parent, which displayed maternal love as a buffer for
the negative effect of the long absence of a parent, could not
be cross-validated, nor could the effect of the absence itself.
All remaining effects explained about 9 % of the variance of
vegetative symptoms in the cross-validation sample.
Pain
The third primary response, pain, retained one linear effect
and one interaction effect after cross-validation (Table 2).
Gender showed a linear effect, i.e. men presented with lower
levels of pain (b
gender
=-0.41, t =-3.88, p \ 0.001;
Fig. 2h). Maternal parentification showed an interaction
with longer absence of a parent. If no parent was absent,
maternal parentification increased the reported levels of
pain. If a parent was absent, maternal parentification dis-
played no association with pain, or may even have decreased
the level of reported pain (Fig. 2i). A positive effect of
paternal parentification could not be cross-validated. The
remaining effects explained the relatively small amount
(7 %) of the variance of pain in the cross-validation sample.
Intermediate Responses
Love and Parentification
Maternal parentification had two predictors: longer absence
and gender (Table 3). They display an interaction. Only
women (i.e. girls) reported high levels of maternal
parentification when a parent was absent during childhood
(Fig. 2j). The effects explained 13 % of the variance.
Paternal parentification had three predictors (Table 3).
Being raised by a single parent (b
single_parent
=-0.49,
t =-5.60, p \ 0.001; Fig. 2k) was associated with low
paternal parentification. Additionally, there was an inter-
action of sexual abuse and the longer absence of one par-
ent, whereby especially those who experienced sexual
abuse as well as a longer absence reported a high risk for
paternal parentification (Fig. 2l).
Maternal love retained three predictors after cross-vali-
dation (Table 3). Sexual abuse (b
sexual_abuse
=-1.00,
t =-9.68, p \ 0.001; Fig. 2m) especially, but also the
longer absence of one parent (b
longer_absence
=-0.43,
t =-5.09, p \ 0.001; Fig. 2n) were associated with low
maternal love. Age and maternal love had a U-shaped
relation, with the lowest levels of maternal love reported by
subjects at age 48, i.e. born in the 1960s (Fig. 2i). These
predictors explained about 26 % of the observed variance in
maternal love. An interaction between sexual abuse and the
longer absence of one parent could not be cross-validated.
Paternal love had five predictors (Table 3). Sexual abuse
(b
sexual_abuse
=-0.44, t =-3.60, p \ 0.001; Fig. 2p),
being raised by a single parent (b
single_parent
=-1.39, t =
-8.76, p \ 0.001; Fig. 2q) and the longer absence of one
parent in childhood (b
longer_absence
=-0.34, t =-3.62,
p \ 0.001; Fig. 2r) were associated with low levels of
paternal love. Additionally, women reported more paternal
love than men (b
gender
=-0.17, t =-1.92, p \ 0.05;
Fig. 2t). As with maternal love, age had a quadratic effect,
describing a U-shaped relationship, with the lowest measures
of paternal love at age 43, i.e. born the 1960s (Fig. 2s). The
explained variance of paternal love was 17 %.
Single Parent, Sexual Abuse and Long-Term Absence
For sexual abuse, only gender remained as a predictor after
cross-validation (Table 3). Women were more likely to
have been sexually abused than men (b
gender
=-0.22,
t =-7.61, p \ 0.001; Fig. 2u), here with an explained
variance of 10 %. A quadratic age effect in the extraction
sample could not be cross-validated.
Having been raised by a single parent had no predictor
in either sample (Table 3). Longer absence of a parent was
predicted by age (Table 3) and was more likely in older
participants (b
age
= 0.08, t = 3.01, p \ 0.01; Fig. 2v), but
only 2 % of the variance was explained.
Discussion
In our study, maternal as well as paternal emotional paren-
tification represented strong risk factors for the development
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Table 2 Predictors of the primary responses
Starting model (construction sample) Selected model (cross-validation sample) Excluded variables
Estim. coeff. SE t value Estim. coeff. SE t value t value
Depressive symptoms—linear regression
Const. 0.86 0.15 5.77 1.19 0.11 10.79
(a) PAR_M 0.18 0.07 2.68 0.40 0.07 5.90
(b) PAR_P 0.71 0.18 3.82 0.31 0.09 3.27
(c) LOV_P -0.13 0.05 -2.48 -0.36 0.05 -7.32
(c) ABS -0.48 0.15 -3.12 -0.40 0.17 -2.35
(c) LOV_P 9 ABS 0.22 0.08 2.60 0.18 0.10 1.78
LOV_M -0.01 0.06 -0.20 0.73
SINGL 0.41 0.14 2.92 -2.73
GEN -0.19 0.07 -2.76 -0.75
LOV_M 9 PAR_P -0.23 0.08 -2.78 -0.44
Selected model: DEP * LOV_P ? PAR_M ? PAR_P ? ABS ? LOV_P 9 ABS R
2
= 26.49 %
Vegetative symptoms—linear regression
Const. 0.93 0.11 8.77 1.17 0.08 14.57
(d) PAR_P 0.33 0.05 6.38 0.31 0.06 5.41
(e) LOV_M 0.06 0.05 1.24 0.07 0.04 1.98
(f) LOV_P -0.08 0.03 -2.33 -0.18 0.03 -3.69
(g) GEN -0.25 0.06 -4.60 -0.25 0.06 -4.25
ABS 0.35 0.17 2.07 0.54
LOV_M 9 ABS -0.20 0.07 -2.72 0.85
Selected model: VEG * LOV_M ? LOV_P ? PAR_P ? GEN R
2
= 8.85 %
Pain—linear regression
Const. 1.45 0.06 23.14 1.57 0.06 26.12
(h) PAR_M 0.18 0.07 2.59 0.18 0.05 3.60
(h) ABS 0.16 0.12 1.29 0.41 0.12 3.54
(h) PAR_M 9 ABS -0.34 0.11 -3.06 -0.24 0.09 -2.80
(i) GEN -0.41 0.07 -6.33 -0.27 0.06 -3.88
PAR_P 0.16 0.07 2.17 0.66
Selected model: PAIN * PAR_M ? ABS ? GEN ? PAR_M x ABS R
2
= 6.59 %
Reading example: The interaction parental love 9 ‘absence of a parent’ had a t value of 2.60 in the extraction sample and of 1.78 in the crossvalidation. It is displayed in Fig. 2c.
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Table 3 Predictors of the secondary and tertiary responses
Starting model (construction sample) Selected model (cross-validation sample) Excluded
variables
Estim. coeff. SE t value Estim. coeff. SE t value t value
Maternal parentification—linear regression
Const. 0.60 0.05 12.98 0.91 0.05 19.83
(j) ABS 0.40 0.09 4.35 0.69 0.10 7.23
(j) GEN 0.16 0.06 2.52 -0.17 0.07 -2.45
(j) ABS 9 GEN -0.36 0.13 -2.72 -0.67 0.14 -4.73
Selected model PAR_M * ABS ? GEN ? ABS 9 GEN R
2
= 13.48 %
Paternal parentification—linear regression
Const. 0.41 0.03 14.25 0.43 0.03 15.09
(k) SNGL -0.24 0.10 -2.57 -0.49 0.09 -5.60
(l) SEX_AB -0.20 0.11 -1.74 0.08 0.08 1.03
(l) ABS 0.07 0.06 1.13 0.15 0.06 2.60
(l) SEX_AB 9 ABS 0.46 0.19 2.49 0.48 0.16 3.07
Selected model PAR_P * SEX_AB ? SNGL ? ABS ? SEX_AB 9 ABS R
2
= 11.11 %
Maternal love—linear regression
Const. 3.06 0.30 10.28 4.83 0.43 11.17
(m) SEX_AB -0.20 0.16 -1.20 -1.00 0.10 -9.68
(n) ABS -0.19 0.10 -1.89 -0.43 0.08 -5.09
(o) AGE -0.04 0.01 -2.75 -0.12 0.02 -5.67
(o) AGE
2
0.0004 0.0002 2.68 0.001 0.0003 5.01
SEX_AB 9 ABS -0.60 0.27 -2.23 1.51
Selected model LOV_M * SEX_AB ? ABS ? AGE ? AGE
2
? SEX_AB 9 ABS R
2
= 25.59 %
Paternal love—linear regression
Const. 3.04 0.34 9.03 4.24 0.53 7.99
(p) SEX_AB -0.52 0.15 -3.47 -0.44 0.12 -3.60
(q) SNGL -0.64 0.16 -4.07 -1.39 0.16 -8.76
(r) ABS -0.41 0.11 -3.86 -0.34 0.10 -3.62
(s) AGE -0.05 0.02 -3.03 -0.12 0.03 -4.58
(s) AGE
2
0.0005 0.0002 2.93 0.001 0.0003 4.49
(t) GEN -0.22 0.08 -2.78 -0.17 0.09 -1.92
Selected model LOV_P * SEX_AB ? SNGL ? ABS ? GEN ? AGE ? AGE
2
R
2
= 17.20 %
Sexual abuse—logistic regression
Const. -6.24 1.89 -3.30 0.23 0.02 11.87
(u) GEN -1.84 0.46 -4.04 -0.22 0.03 -7.61
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of depressive symptoms in adulthood (Figs. 2a, b).
Regarding the direction, these results were in accordance
with earlier studies (Chase 1999; Hardt 2004a; Jurkovic
1997); regarding the magnitude, the effect was even stronger
in this analysis than the average of a recent meta-analysis for
parentification and adult psycho-pathology (r = .14: Hooper
et al. 2011). A child that has to be concerned about his or her
parents’ emotional needs is burdened with a deficit of care
(Schier 2010), in a certain way, he or she is neglected
(Hooper 2007). As an example, a female psychotherapy
patient in her forties parentified both emotionally and
instrumentally shall be cited: ‘During my whole life I was
looking for a mother that I never really had. It was like living
with a black hole, with a continuous lack of something
important’ (Schier 2009). In our study, maternal and pater-
nal parentification constituted the strongest predictors of
depressive symptoms, which, along with paternal love and
longer absence of a parent, yielded a high amount of
explained variance (26 %). Paternal love had a protective
effect on depressive symptoms, though the effect was
smaller when one parent was partly absent (Fig. 2c). Sur-
prisingly, there was no protective effect of maternal love on
depressive symptoms, though this has been found in previous
clinical samples (Schier et al. 2011) and for adolescents
(Khaleque 2013). There was such an effect in the extraction
sample, but it failed to reach significance in cross-validation.
One possible explanation for the missing effect is that of
idealization. Idealization is a defense mechanism often
used to preserve the ‘good’ internal representation of a
person to enable coping with the subject’s negative feelings
(Schier 2009, 2010). Conceptually, idealization is similar
to splitting—it can be regarded as one side of the coin. If
we accept the idea that high values in the scale ‘love’ in
the childhood questionnaire can reflect the truth, but could
also be an effect of idealization of a caregiver, our results
are easier to understand. According to Wells and Jones
(1998), individuals who have experienced deprivation,
frustration, and insufficient care as children tend to cope
with conflict by using the defensive mechanism of splitting.
Wells and Jones(1998) state that splitting ‘allows indi-
viduals to avoid mixing their one quart of sweet milk’’—
i.e. good self-object relationship experiences—with ‘three
quarters of sour milk’’—i.e. negative self-object relation-
ship experiences’ (p. 333). Splitting moderates the devel-
opment of idealization (Schier 2010). We think it is not
‘love’ from the mother in childhood that constitutes the
risk factor for development of parentification, but rather the
idealization of the mother, which could play a role as a
defense mechanism. In our culture there is a strong ten-
dency to idealize one’s mother. It is more socially
acceptable to blame the father for various negative child-
hood experiences (Guziak 2010; Schier 2009). Further
research should be done to investigate why maternal love
Table 3 continued
Starting model (construction sample) Selected model (cross-validation sample) Excluded
variables
Estim. coeff. SE t value Estim. coeff. SE t value t value
AGE 0.19 0.08 2.27 0.50
AGE
2
-0.002 -0.0009 -2.13 0.34
Selected model SEX_AB * GEN Pseudo-R
2
= 10.25 %
Longer absence of parent—logistic regression
Const. -5.02 0.48 -10.40 0.04 0.07 0.52
(v) AGE 0.08 0.009 8.92 0.005 0.002 3.01
Selected model ABS * AGE Pseudo-R
2
= 1.58 %
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does not necessarily have a buffer effect in the relationship
between parentification and depression.
The two response variables indicating somatization, i.e.
vegetative symptoms and pain, exhibited much less
explained variance than depressive symptoms. This came
as a surprise because we expected a high association.
Parentified individuals are said to be less able to perceive
their feelings than non-parentified persons (Guziak 2010).
Therefore, it is to be expected that they express their
psychological distress indirectly instead, i.e. in the form of
somatization as vegetative symptoms or pain. This was
definitely not the case here. However, there were some
associations in our data that supported the idea of somati-
zation as a consequence of parentification: paternal par-
entification predicted vegetative symptoms, which could be
signs of psychological distress (Schier 2010); maternal
parentification predicted pain. The association between
mother–child relationships and the development of vege-
tative symptoms seems to be more complicated, or perhaps
the mechanism is simply less apparent. For example, it is
difficult to explain why maternal love was associated with
a higher rate of reported vegetative symptoms.
The risk of developing pain is increased by maternal but
not by paternal parentification (Fig. 2i). This held true only
when the father was present during childhood, not when he
was absent for some time. It is likely that children are
better able to cope with maternal parentification when there
is a ‘reason’’ for it. It is also likely that they can endure and
accept not only instrumental but also emotional parentifi-
cation more easily when they perceive it as fair (Jurkovic
1997; Schier 2009).The symptoms assessed with the pain
scale of the SCL-27-plus, i.e. headaches, chest pains,
muscle cramps, muscle pain, pain in arms and legs and
backaches, can be regarded as signs of somatization, much
like vegetative symptoms. Examining parentification from
a symbolic perspective, we can say that the trauma of
parentification is processed in one’s body. Patients interpret
their psychological pain as a bodily sensation. The status of
a parentified person’s relationship with their mother seems
to be of importance. Wachowiec (see Schier 2010; Schier
et al. 2011) was able to prove that there is a relationship
between the strategy of coping with pain and perception of
the ill organ in patients with chronic back pain: the more
active the patients’ coping strategies were, the more intense
was the perception of their back pain. According to a
number of authors (PDM 2006), defense and coping
mechanisms (also in regard to dealing with pain) are
developed in the course of a child’s relationship with his or
her mother in early childhood (Gerhard 2004; PDM 2006;
Schier 2010).
We have to conclude that in our study, the relationship
between parentification and indicators of somatization, i.e.
vegetative symptoms and pain, was confounded by the
possibility that some individuals, though regarded as
somatizers, may have a physical illness that explains their
somatic symptoms. However, we should also consider the
possibility that our assumptions concerning psychological
mechanisms of somatization are in need of a revision.
Our model has also identified risk factors for the
occurrence of parentification: girls in families where a
parent is temporarily absent are at risk for maternal par-
entification, paternal parentification is likely to be experi-
enced by sexually abused children and also in the case of
an absent parent. Here, we have identified two groups that
should receive more attention in terms of psychological
support and psychotherapy. Other effects that might have
been expected were not found. Obviously, one would have
expected a higher rate of parentification in single parent
families, but according to our data, this was not the case.
Maternal love and paternal love were associated with
similar risk factors. Sexually abused children reported much
less love from both parents, an effect that has been observed
before (Schier et al. 2011) but which was much more pro-
nounced in these samples (Figs. 2j, m). In one of our pre-
vious investigations (Hardt 2004a), the hypothesis that
maternal love may constitute a protective factor particularly
for physically or sexually abused or neglected children
emerged. However, we were unable to confirm this
hypothesis (Hardt 2004b). With respect to sexual abuse, the
present data offered an answer: there are not many sexually
abused children who perceived much love from their
mothers. With respect to age, the present data also repli-
cated a previous finding: subjects who grew up in the post-
war years reported less love than those born earlier or later.
Effects were also stronger than in previous investigations
(Figs. 2l, r). We interpreted this finding as strong evidence
against the cliche
´
: ‘We were poor after the war but our
family always held together’’. On the contrary, the data
clearly showed that the Second World War had a deep
impact on family life: many children became emotionally
neglected (Hardt, Dragan, Schultz, and Engfer
2011).
Less maternal love was reported when the father was
absent, and paternal love was lacking almost entirely from
the figure children chose as a substitute for their fathers in
single parent families (Figs. 2k, o). The first effect is
plausible: mothers may suffer from the absence of their
husbands and be unable to give much love to their children.
The second effect is dramatic given the growing number of
children living in single parent families (Franz and Lensche
2003) or children experiencing their parents divorce,
especially in light of the result from our study that parental
love is protective for the development of vegetative
symptoms. Our results have indirectly confirmed the results
of the study by Jurkovic et al. (2001), who investigated the
role of parentification in families of young adults whose
parents are divorced. The authors observed that ‘the
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divorced group reported providing more emotional and
instrumental caregiving and experiencing more unfairness
in their families of origin than the nondivorced group’ (p.
245). The consequences of a couple’s divorce on the
development of the child could therefore be more dramatic
than we may generally assume.
In our study, we observed a diversification of results in
accordance with gender. Maternal parentification was
particularly high for girls when the father was absent
(Fig. 2m). Boys were not at risk. Paternal parentification
was low in single parent families (Fig. 2s), which is logical
because often it was the father who was absent. Addi-
tionally, abused children reported high maternal parentifi-
cation when the father was absent. Sexual abuse was
reported more often by girls than boys (Fig. 2t), a fact that
is well known (Hardt 2004a). In these two samples
Fig. 2 Types of associations between the variables (Sd
resid
is the standardized residual of the equation; otherwise, the individual group standard
deviations are displayed)
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especially, the cross-validation group had a high rate of
abuse in women, a result that has been discussed elsewhere
(Hardt, Dragan, Schultz, and Schier, 2011). The risk of one
absent parent increased linearly with age, which is likely to
be partly an effect of the Second World War. Our results
have also confirmed earlier findings (Chase 1999; Jurkovic
1997) that girls are more often burdened by emotional
parentification in the family.
According to results from previous studies (e.g. Hardt
et al. 2007; Woolgar and Murray 2011), we would have
expected interactions between perceived love and
parentification. However, we did not find any. Particularly
the combination of low love and high parentification was
expected to be associated with poor mental health in
adulthood. This was not the case in here, effects were
solely linear and additive.
In interpreting the results of our study from the per-
spective of attachment theory, we have underlined the
strength of associations between parentification in child-
hood and various complaints in adulthood. The role
mothers play in families of parentified children seems to be
much more complex than the father’s role. Studies on
Fig. 2 continued
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sexual abuse in the family (e.g. Beisert 2004) confirm that
children blame their mothers if they are abused by their
fathers. They feel neglected and betrayed. A psychological
mechanism that allows these individuals to work through
this is the mechanism of dissociation and/or idealization
described above.
Overall, compared to our previous investigations (Hardt
2004a), effects of father-child relationships were more
pronounced in these samples, effects of the mother–child
relationships less. Several possible explanations should be
mentioned. First of all, the data in our study was collected
about 8 years later than the data from our previous inves-
tigations. It is possible that the importance of fathers in
families has increased over time, in accordance with the
change of cultural circumstances. Secondly, our previous
investigation was conducted with subjects visiting their
general practitioner (GP) and we believe there may be
differences between these individuals and the general
population. This may be in terms of various psychological
mechanisms, among them the mind–body connection.
Schilte and Portegijs (2001), Schilte et al. (2000) state
that ‘[i]n primary care [], patients with psychosocial
disturbances may present with distress-related physical
symptoms’’ (p. 276). There is substantial literature attesting
to somatization in individuals who have little control over
their life and are living in cultures in which the verbal
expression of emotion is discouraged (Schier 2009). It is
however possible that these associations are specific to
clinical populations. The parentified subjects in our non-
clinical study could in some ways be more realistic than
patients visiting a doctor and seeking medical help.
According to attachment theory and to theories on soma-
tization (PDM 2006), patients with a tendency to present
with unexplained medical symptoms (who very often reg-
ular visit their GP’s) are using their bodies to ‘express’
psychological distress, meaning they are lacking in self-
regulatory strategies which are normally obtained in the
early relationship between a child and his or her mother
(Gerhard 2004; Schier 2010).
The present study has the following limitations. First, all
data are in the form of self-reports, no clinical diagnoses
were obtained. Though studies comparing health in self-
reports with objective health status have shown correla-
tions between the two, these were not always large and
usually restricted to specific illness groups (Wu et al.
2013). Second, current symptoms were taken as primary
responses. Since some symptoms may have a fluctuating
course (e.g. depression), complaints of subjects who cur-
rently feel well but who have had serious phases of
impairment are missed (Westheide et al. 2008). Third,
childhood adversities were assessed retrospectively. There
is an ongoing critique on how valid such data are (e.g.
Widom et al. 2004; Yarrow et al. 1970), while other studies
support the use of retrospective data from childhood (e.g.
Hardt et al. 2010). Fourth, relationships were analyzed in a
linear model in this case. However, it is clear that rela-
tionships between parents and their child are in fact reci-
procal (e.g. Pearl et al. 2011). Fifth, the present analysis is
restricted to few variables. Many others may be important
within this context.
Despite these limitations, we believe that the present
investigation adds new aspects to our views on emotional
parentification. In our study, we have differentiated
between maternal and paternal parentification, which has
allowed us to comprehend the diversified pathways of long-
term sequelae of parentification. The results of our study
have confirmed the existence of long-lasting consequences
of destructive parentification in childhood. Byng-Hall
(2002) states that: ‘Parentification is far more prevalent
than would be expected in its coverage in the literature’ (p.
387). If and when researchers and clinicians are prepared to
address this problem, the misery that has to be endured by
people during childhood and later when they are adults
could be significantly reduced. Still, it is important to stress
that the differentiation between destructive and construc-
tive parentification should always be made. The first leads
to various sequelae in adult life and is considered traumatic
for an individual, especially if it remains chronic and
untreated. The second, on the other hand, can in certain
circumstances expedite posttraumatic growth of a person
(Hooper et al. 2008). Future research should focus on how
to diagnose and distinguish between these two types of
parentification in families.
Acknowledgments The authors thank an anonymous reviewer from
J Child Fam Stud for constructive suggestions on a previous version
of this paper.
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... First, parentification can be labeled as emotional or instrumental. Emotional parentification refers to the child satisfying the emotional and social needs of other family members as well as facilitating a caring, positive atmosphere in the family, which may involve the child becoming, for example, a parental therapist or confidant (Hooper et al., 2011;Schier et al., 2015). Instrumental parentification relates to the involvement in functional tasks aimed at caring for the physical and daily living needs of the family members (e.g., cleaning, raising siblings, providing money for the family; Earley & Cushway, 2002;Hooper et al., 2011). ...
... found (Cho & Lee, 2019;Vulliez-Coady et al., 2013), as well as studies showing that females report higher parentification than males (Byng-Hall, 2008;Schier et al., 2015;Stein et al., 1999;Thomas, 2017) or that males report higher parentification than females do (Arellano et al., 2018;Hooper et al., 2015). At the same time, researchers point out that parentification in boys may be underreported and underestimated as they may be reluctant to admit to carrying out tasks that are considered as not in line with the gender stereotype. ...
... Therefore, future studies on parentification should investigate if Polish mothers and fathers expose their children to different levels of parentification (comp. study from a German sample, Schier et al., 2015). ...
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... With this type of parentification, children can act as confidants, comforters or mediators. Both emotional and instrumental parentification are not exclusive and may coexist on various levels (Schier et al., 2015). Studies indicate that emotional parentification may be more deleterious and destructive than instrumental parentification (McMahon and Luthar, 2007;Tompkins, 2007;Byng-Hall, 2008). ...
... Therefore, students that took part in this study could have been specific and come from families where the level of emotional parentification was rather low. On the other hand, the level of emotional parentification could have been underreported in this sample [e.g., due to adolescents' defense mechanisms aimed to present a positive image of the parent despite the adversities (see Schier et al., 2015)]. The underreporting of emotional parentification in this sample could also be rooted in the culture. ...
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... A lack of boundary differentiation is associated with increased risk for depressive symptoms as well as higher rates of anxiety in youth which extends into adulthood (Champion et al., 2009;Schier et al., 2014). Generally, children of depressed mothers seem to respond more to their mothers' internal states (Radke-Yarrow et al., 1993), possibly due to the caregiving/parentified role in which these children are placed. ...
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