The Role of Parent-Adolescent Relationship Quality in the Functioning of Anxious Adolescents

Abstract

There is growing recognition that the reciprocal relationships between adolescents and their parents play an important role in the development and maintenance of mental health problems for young people. However, the unique contributions of the different aspects of parent-adolescent relationship quality to adolescent functioning remain unclear. This thesis aimed to test a theoretical model of how parent-adolescent relationship quality (i.e., connectedness and hostility) mediated the relationship between adolescent anxiety and adolescent functioning (i.e., positive development and oppositional defiant behaviour), and to evaluate the effectiveness of a brief parenting intervention in improving adolescents’ relationships with parents and adolescent outcomes.Three studies were conducted with parents and their adolescents aged 11 to 17 years living in Australia. Study I was a single time-point community survey completed by 723 parents and 72 adolescents designed to investigate the links between demographics, adolescent anxiety, parental wellbeing, parenting practices, parent-adolescent relationship quality and adolescent functioning. Multivariate correlational analyses demonstrated that parent-adolescent connectedness and hostility were significant correlates of adolescent functioning. Other significant predictors of adolescent functioning included sociodemographic variables (parent age, parent cultural and educational backgrounds, adolescent gender and age and household financial stress), level of adolescent anxiety, as well as parental psychological distress, parental psychological flexibility (cognitive defusion, committed action and acceptance) and parenting practices (positive parenting, inconsistent discipline and poor supervision). Moreover, hierarchical multiple regression analyses showed that parent-adolescent connectedness and hostility were unique predictors of adolescent functioning after accounting for demographics, adolescent anxiety and parental factors. Parent-adolescent connectedness was not identified as a potential mediator on the link between adolescent anxiety and adolescent functioning. However, mediation analyses indicated that parent-adolescent hostility had an impact on reducing the influence of adolescent anxiety on positive development as well as on oppositional defiant behaviour. This provided some support for the role of parent-adolescent relationship quality in increasing positive outcomes and reducing the risk of developing disruptive and oppositional behaviour for adolescents with higher levels of anxiety.Study II was an observational study conducted with 15 parent-adolescent dyads that investigated the utility and psychometric properties of a parent-adolescent observation task and coding scheme in measuring the quality of parent-adolescent interactions. The observational measure was found to have good internal consistency and discriminant validity. However, results for construct validity were mixed. Significant correlations were revealed between two of the eleven items evaluated on the Connectedness/Hostility subscale of the observational measure (i.e., adolescent’s response and adolescent’s focus) and corresponding subscales measuring the constructs of connectedness and hostility on an existing self-report measure of parent-adolescent relationships, the Parent-Adolescent Relationship Scale (PARS). Participants were assigned to an Anxiety Disorder group or a No Disorder group based on DSM-5 criteria for anxiety disorders. Statistically significant differences were found between groups on the PARS Hostility subscale, as well as three items on the observational measure’s Connectedness/Hostility subscale (i.e., General Mood, Adolescent’s Response and Adolescent’s Focus). Study III was a pre-post evaluation of the effectiveness a 2-hour Triple P Discussion Group on promoting parent-adolescent relationships and adolescent functioning with 12 parentadolescent dyads. No significant differences were revealed when comparing scores on the questionnaires measuring adolescent anxiety, parental psychological distress, parental psychological flexibility, parenting practices, parent-adolescent relationship quality and adolescent functioning across the two time points, with the exception of a significant decrease in PARS Connectedness reported by parents. Three of the eleven items evaluated on the observational measure’s Connectedness/Hostility subscale (i.e., general mood, adolescent’s response and adolescent’s focus) showed statistically significant differences from pre- to postintervention, but did not meet criteria for reliable change, which suggested the changes observed were not clinically significant.Overall, these findings supported the notion that parent-adolescent relationship quality is a critical factor impacting adolescent functioning and should be addressed when determining ways to improve behavioural outcomes for anxious adolescents. The present study also highlighted the value of including both parent and adolescent perspectives and multiple assessment modalities in adolescent developmental research. Further modification and development of the observational tool as a valid measure of parent-adolescent relationship quality is recommended. Although results from the intervention study were not found to be clinically significant, it was unclear if this was due to the small sample size and relatively homogenous profile of participants recruited to Studies II and III or the effectiveness of the intervention. Suggestions are made for investigating a modified version of the observational measure that could be sensitive to intervention effects with a larger and more diverse sample.