Parental Overprotection Research Articles

Differences in perceived parental practices across attachment styles in adult children of alcoholic fathers

BackgroundAlcoholism is a growing problem in Pakistan. Problems related to alcoholism affects the family members especially children of alcoholics who are likely to have biased perceptions of parental practices which in turn affects their attachment patterns. ObjectiveTo analyze the differences in perceptions of parental practices across three attachment styles namely avoidant, anxious/ambivalent, and secure attachments of the adults who are children of alcoholic parents. MethodThe study is a correlational research design with a sample of 330 participants selected through purposive sampling technique. The participants were adults who are children of alcoholics from nuclear family systems, whose fathers were admitted in a rehabilitation center for the treatment of alcoholism for the second time. ResultsMANOVA computed to examine differences in perception of parental practices across attachment styles was significant [F(12, 632) = 53.130, p < .001, Pillai's Trace = 1.003, partial eta squared = .501], indicating that those with different attachment styles perceive parental overprotectiveness, emotional warmth, and rejection differently. ConclusionPerceptions about parental practices for father can be linked with alcoholism, while for mother the perceptions about parental practices are a product of attachment mainly. ImplicationsThe findings can be used to devise counseling and therapeutic plans for adults who are children of alcoholics and help in educating them about the condition of alcoholism.

대학생이 지각한 부모양육태도가 도박행동에 미치는 영향

Objectives The purpose of this study is to investigate the relationship between the parenting attitude, self-control, and gambling behavior of college students. Methods For the purpose of this research, data was gathered through self reported expression questionnaires, the subjects were 248 college students in the Gangwon-do areas. Descriptive statistics, Descriptive statistics, correlation analysis and regression analysis were conducted to determine the relationship between the parenting attitude, self-control and gambling behavior. Results The results of this study are as follows. First, parenting attitude of perceived by college students, self-control and gambling behavior of the perceived by the college students were statistically significant. Second, emotional warmth parenting attitude is a fully mediating effect on the relationship between self-control and gambling behavior, rejective parenting attitude is a partial mediating effect on the relationship between self-control and gambling behavior, overprotective parenting attitude is a fully mediating effect on the relationship between self-control and gambling behavior. Conclusions We discussed prevent gambling behavior and preparing the basis for intervention in gambling addiction among college students were presented, and Implications for coping with gambling behavior were discussed.

Parental care interacts with dopamine β-hydroxylase gene in trait of forgiveness with differential susceptibility effect

ABSTRACT Forgiveness, an emotion regulation strategy for overcoming personal distress and healing injuries following interpersonal conflicts, is greatly modulated by parental bonding (e.g. parental care and overprotection) and genetic predispositions. Inspired by the roles of dopamine β-hydroxylase (DBH) gene in empathy and emotion regulation, we examined how parental bonding interacted with the DBH-1021C/T (i.e. a polymorphism accounts for 35–52% of variance in DBH activity) in forgiveness. Results indicated that (1) the score on forgiveness was positively related to parental care, but negatively related to parental overprotection; (2) parental care significantly interacted with the DBH-1021C/T in forgiveness with differential susceptibility model. The TT/CT genotypes were related to lower forgiveness than the CC genotype among individuals with lower parental care, butwere related to higher forgiveness among individuals with optimal parental care. These findings provide a new insight into the gene–environment interaction in the development of forgiveness.

Anxiety-Promoting Parenting Behaviors in Adolescents with Social Anxiety: Controlled with a Non-Clinical Sample.

: The majority of research on parenting behaviors in social phobia has been conducted with mother-child dyads, but there is still a gap in current knowledge about the role of fathers' parenting behaviors and adolescence period. This study focuses on the role of parent gender, parental attitudes, and familial factors in an adolescent population. Our study sample consisted of adolescents diagnosed with social phobia (n = 60), healthy non-clinical adolescents (n = 30), and the parents of adolescents with social phobia (n = 46) and non-clinical adolescents (n = 30). A Sociodemographic Information Form, Family Interview Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Liebowitz Social Anxiety Scale, and The Parent Attitude Research Instrument were administered to all groups. The parents of adolescents with social phobia have reported a higher overprotective mothering attitude when compared to parents of healthy adolescents (P mother < .001 and P father = .009). The mothers' overprotective parenting style and the fathers' avoidance levels were found as predictive factors for adolescents' social phobia in logistic regression analysis (respectively; exp(β) = 0.868 and P = .002; exp(β) = 0.927 and P = .017). Our results indicate the necessity of considering both the parents in the research. We suggest that controlled prospective future studies on different ages, diagnostic groups, and cultures, which will take the gender of both parents and patients into account, may reveal important data on the relation between parenting behaviors and social anxiety.

To endure or to resist? Adolescents' coping with overprotective parenting

Scholars typically consider parental overprotection to be a maladaptive type of parenting with negative repercussions for adolescents' psychosocial adjustment, with frustration of adolescents' psychological needs serving as an underlying mechanism behind these effects. However, little is known about how adolescents cope with overprotective parenting and how adolescents' coping can alter associations between perceived overprotective parenting and adolescents' maladjustment. In the present study, we examined the moderating role of four coping strategies (i.e. compulsive compliance, oppositional defiance, negotiation and accommodation) using a moderated mediation model based on cross-sectional data of 382 Belgian adolescents (Mage = 17.1 years, 44.5% male). Overall, the results showed that adolescents' coping with overprotective parenting alter to some extent the strength of associations between overprotective parenting and developmental problems. Compulsive compliance in particular appears to be a maladaptive strategy in the context of overprotective parenting. Overall, the results underscore adolescents' active role in overprotective parenting.

Intergenerational transmission of child-rearing styles mediated by adult attachment: A structural equation model approach.

Parenting styles are determinants of psychosocial maladjustment in the subsequent generation. Modifiable factors that positively impact intergenerational transmission should be identified. Thus, this study investigated the mediating effects of adult attachment on the transmission of child-rearing styles and the combined impact of fathers' and mothers' styles on their offspring's parenting. Overall, 396 fathers and 733 mothers participated. They were married or cohabiting when their children aged 0-10 years attended a pediatric office in Japan. The pediatricians distributed the self-report questionnaires to examine perceived rearing (the Parental Bonding Instrument), adult attachment (the Relationship Questionnaire), and demographic characteristics. We then analyzed the data using structural equation modeling that illustrated intergenerational transmission of rearing styles between grandparents and parents. Overall, 385 fathers (M age = 35.5 years, SD = 6.0) and 699 mothers (M age = 33.5 years, SD = 5.1) satisfied the eligibility criteria. The path models showed that adult attachment to partners mediated grandparental and parental care. However, no mediating effect was observed in other intergenerational patterns that transmitted overprotective rearing styles. Additionally, combined grandfather and grandmother care were positively associated with parental overprotection. This study suggested the potential of adult attachment in mediating loving, empathic, and warm rearing styles and the combined effects of both parents' styles on promoting the next-generation parents' overprotective styles. Our findings clarify how to terminate the negative chain of the parent-child transmission.

What makes a violent mind? The interplay of parental rearing, dark triad personality traits and propensity for violence in a sample of German adolescents.

Machiavellianism, narcissism and psychopathy are socially aversive personality traits that are strongly linked to the propensity of violence. A central determinate of aggression and violence is parental rearing. Interestingly, while the origin of the development of Dark Triad is not yet entirely understood, next to genetic and environmental factors, literature points towards an influence of parenting styles to the development of dark traits. Therefore, in a sample of 1366 9th grade students (mean age 14.89,), we assessed the interplay between parental rearing, dark triad traits, observation of violence among peers and their propensity for violence. The sample has a good representativeness on school types. Results reveal a positive association between the experience of parental rejection by both parents and punishment as well as parental control and overprotection and Machiavellianism, narcissism and psychopathy. Parental emotional warmth was associated negatively with Machiavellianism and psychopathy while no significant association with narcissism was seen. In a path model, parental rearing, dark triad traits and observation of violence among peers significantly contributed to the propensity of violence. However, differences between the experienced parenting behaviour of mothers and fathers should be noted. Both rejection and overly harsh punishments by fathers and emotional warmth by mothers have no significant influence on the dark triad. It is interesting that the effects regarding maternal parenting behaviour are stronger overall than the effects regarding paternal parenting behaviour. These results underline the importance of parental rearing on the development of Machiavellianism, narcissism and psychopathy and suggest a significant role of parental rearing and the dark triad traits on propensity for violence in adolescents. Parenting trainings and family interventions may be a promising starting point to prevent antisocial behavior linked to the dark triad and to prevent violent behavior in future generations

The interplay between parental care and OPRM1 in reward responsiveness

The Reinforcement Sensitivity Theory (RST) explains a variety of reward-motivated behaviors as the result of the activation of biologically-based systems. Inspired by the influences of parental bonding and opioid peptide on reward system, we investigated the contributions of parental bonding and mu-opioid receptor gene (OPRM1) towards motivation systems (i.e., the BAS, BIS-anxiety, and FFFS-fear). Results indicated that (1) parental care was negatively related to FFFS-fear, but parental overprotection was positively related to both FFFS-fear and BIS-anxiety; (2) parental care significantly interacted with OPRM1 rs1799971 in reward responsiveness with diathesis-stress model. Poor parental care reduced reward responsiveness among individuals with the G allele, but not those with the AA genotype. These findings from this study demonstrate a new gene-environment interactive mechanism of the RST.

Nature-Based Relaxation Videos and Their Effect on Heart Rate Variability.

Growing evidence suggests that natural environments – whether in outdoor or indoor settings – foster psychological health and physiological relaxation, indicated by increased wellbeing, reduced stress levels, and increased parasympathetic activity. Greater insight into differential psychological aspects modulating psychophysiological responses to nature-based relaxation videos could help understand modes of action and develop personalized relaxation interventions. We investigated heart rate variability (HRV) as an indicator of autonomic regulation, specifically parasympathetic activity, in response to a 10-min video intervention in two consecutive studies as well as heart rate (HR). We hypothesized that a nature-based relaxation video elicits HRV increase and HR decrease, with response magnitude being affected by aspects of early life adversity (conceptualized as low parental care and high overprotection/constraint) and trait mindfulness. In Study 1, N = 60 participants (52% female, agemean = 23.92 ± 3.13 years, agerange = 18–34 years) watched a relaxation video intervention depicting different natural scenery. We analyzed changes in HR and respiratory sinus arrhythmia (RSA) as a standard HRV measure, both based on 3-min segments from the experimental session, in multiple growth curve models. We found a decrease in HR and increase of RSA during the video intervention. Higher paternal care and lower trait mindfulness observing skills (assessed via questionnaires) were associated with higher RSA values before but not during video exposure. In Study 2, N = 90 participants (50% female, agemean = 22.63 ± 4.57 years, agerange = 18–49 years) were assigned to three video conditions: natural scenery from Study 1, meditation video, or short clip from “The Lord of the Rings.” Again, HR decreased, and RSA increased during video segments, yet without expected group differences across different video types. We found higher parental care and lower parental overprotection to predict higher RSA at different times during the experiment. Interestingly, lower paternal overprotection predicted overall higher RSA. These results suggest a generic relaxation effect of video interventions on autonomic regulation that we discuss in light of different theories mapping restorative effects of natural environments. Further, psychological characteristics like aspects of early life adversity and trait mindfulness could contribute to individual differences in autonomic regulation. This study contributes to a better understanding of autonomic and psychological responses to relaxation videos.

Behavioral Inhibition in the Second Year of Life Is Predicted by Prenatal Maternal Anxiety, Overprotective Parenting and Infant Temperament in Early Infancy.

BackgroundBehavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty.Materials and MethodsAs part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in N = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum.ResultsMediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty p < 0.001 and maternal overprotection (p < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting (p < 0.05).ConclusionResults indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.

The psychometric qualities of a short version of the multidimensional overprotective parenting scale

ABSTRACT The Multidimensional Overprotective Parenting Scale (MOPS) is a 35-item questionnaire assessing two dimensions of parental overprotection. Given its substantial length, the present research presents the development and psychometric properties of a short version of the MOPS (S-MOPS). Four independent samples were used (Sample 1, N = 315 Swiss adolescents; Sample 2, N = 377 Belgian adolescents and young adults; Sample 3, N = 312 Georgian young adults; Sample 4, N = 467 Swiss parents). Item selection based on factor analysis resulted in a 16-item version, comprising 10 items for anxious overprotection and 6 for ego-enhancing overprotection. The psychometric properties of the S-MOPS were similar to those of the MOPS across samples with high reliability, a stable two-factor structure, and very similar associations with theoretically relevant parenting and adjustment variables. Overall, the S-MOPS appears to be a promising instrument for use in cross-national research and research with a multi-informant approach.

Which mother-headed households' parenting styles are related to children's behavior problems? A cross-sectional study.

SummaryIntroductionParenting styles are considered as one of the main determinants of individual and social behaviors and the use of dysfunctional styles can create child behavioral problems. The aim of this study was to determine the relationship between mother-child relationship patterns in mother-headed households and children’s behavioral problems.MethodsThis is a descriptive-analytical cross-sectional study that was performed on 345 mother-headed households under the coverage of the Imam Khomeini Relief Committee in Shiraz, Iran. Mothers were selected by convenience sampling method and data were collected using several questionnaires including the mother-child relationship evaluation, the child behavior checklist, and social support appraisals scale. Data were analyzed using SPSS software version 21.ResultsThe overprotective parenting style, as one of the inefficient models has been used more than others by mother-headed households as well as the mothers with higher education levels used less from the child-rearing style “ excessive ease “, and benefited more from the support of friends and others. In addition, children of divorced and low-income mothers are more prone to externalizing behavioral problems. The final result was also determined two parenting styles “excessive ease and overprotection” are effective on children’s total behavioral problems.ConclusionThe findings highlight the need to plan and expand socio-economic and educational support services to improve living conditions and parenting skills in mother-headed households. Further research is also suggested to identify the determinants and types of interventions affecting mother-child relationships, children’s behavioral problems, and finally quality of life among this low-income and vulnerable group.

Caregivers’ Difficulty in Managing Smartphone Use of Children with Attention-Deficit/Hyperactivity Disorder during the COVID-19 Pandemic: Relationships with Caregiver and Children Factors

This study examined the difficulty encountered by caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in managing children’s smartphone use during the coronavirus disease 2019 (COVID-19) pandemic and the caregiver- and children-related factors that influence this difficulty. In total, 252 caregivers of children with ADHD were recruited into this study. The caregivers completed a research questionnaire to provide data regarding the difficulty they encountered in managing the smartphone use of children during the COVID-19 pandemic, their general mental health and parenting styles, and the ADHD and oppositional defiant disorder (ODD) symptoms of the children they are caring for. The results indicated that almost 45% of the caregivers of children with ADHD sometimes or often found it difficult to manage the smartphone use of children with ADHD during the COVID-19 pandemic. For the caregivers, a short duration of education, poor general mental health, unaffectionate/uncaring and overprotective parenting styles, older children, and inattention and ODD symptoms were significantly associated with increased difficulty in managing their children’s smartphone use during the COVID-19 pandemic. On the basis of the relevant factors identified in this study, an intervention should be developed to enhance the skills of caregivers of children with ADHD with respect to the management of children’s smartphone use during the COVID-19 pandemic.

How parental smartphone addiction affects adolescent smartphone addiction: The effect of the parent-child relationship and parental bonding

BackgroundAdolescent smartphone addiction (ASA) has fueled concerns worldwide regarding the negative health effects. This study aimed to examine whether parental smartphone addiction (PSA) affected ASA, and evaluated the mediating role of the parent-child relationship and the moderating role of parental bonding in the effect from PSA to ASA, among a Chinese sample of parent-child pairs. MethodsA large-scale cross-sectional survey was conducted among 10- to 15-year-old students and their parents. ASA and PSA were assessed by Mobile Phone Addiction Index (MPAI). The parent-child relationship was evaluated by Child-Parent Relationship Scale-Short Form (CPRS-SF), and parental bonding was estimated by Parental Bonding Instrument (PBI). Conditional process model was used to examine the relationship between PSA and ASA, as well as the mediating effect of parent-child relationship and the moderating effect of parental bonding. ResultsA total of 9515 adolescents and their parents completed the online survey. PSA significantly positively predicted ASA (B = 0.488, p < 0.001). The parent-child relationship negatively mediated the association from PSA to ASA (B = −0.321, p < 0.001). Parental overprotection moderated the indirect path from PSA to ASA through the parent-child relationship (B = −0.016, p < 0.001), but parental care had not any moderation (B = −0.005, p > 0.05). Specifically, parental overprotection had a positive moderating effect on the second half mediation path. The indirect effect of PSA on ASA through parent-child relationship was greater in higher overprotection than in lower. LimitationsCross-sectional study of self-administrated questionnaires. ConclusionsAdolescents had a higher tendency toward smartphone addiction when their parents excessively used smartphones. The findings highlighted the essential role of parent-child relationship and parental bonding in the association from PSA to ASA.

Maternal and paternal overprotection of children born preterm: Relations to child and parental factors.

The purpose of this study was to investigate the correlates of observed overprotective behaviors of mothers and fathers of preterm-born preschoolers. Participants included 85 children born prematurely (gestational age <37 weeks) and their parents, assessed when children were 12, 24, and 42 months old. Observed overprotection was measured through the standardized observation of a parent-child interaction. The examined correlates included parent-reported perception of their protective behavior, parental gender, child neonatal risk, child development, parent-reported perception of child vulnerability, parent-reported psychological distress, and family's socioeconomic disadvantage. Results revealed that the correlation between parent-reported and observed parental overprotection was not significant for mothers and fathers. There was a significant positive association between maternal and paternal observed overprotection and no significant differences between mothers' and fathers' overprotection levels. Lower child developmental level and more socioeconomic disadvantage at child's 12 months of age were significant predictors of observed overprotective behaviors. Findings suggest the importance of targeting parents of preterm-born children with socioeconomic disadvantages and whose children have a lower developmental level for providing support to both mothers and fathers in the development of more adaptive parenting strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parents’ Storm and Stress Beliefs about Adolescence: Relations with Parental Overprotection and Parental Burnout

In society and its mass media, adolescence is typically portrayed as a disruptive and rebellious stage of life (“Storm and Stress”). Previous research suggests that the parental adherence to these negative Storm and Stress beliefs about adolescence are persistent and predict subsequent “Storm and Stress” behaviours among their adolescent children. However, the way these beliefs may impact parenting and the experience of being a parent remains unclear and understudied. This study examined associations between parents’ Storm and Stress beliefs about adolescence and parental burnout as well as explored the potential mediating role of parental overprotection in this association. Using an Actor-Partner Interdependence Partial Mediation Model, we examined these associations in 146 mother-father dyads (<em>N</em> = 292 parents) of adolescents. Results indicated that mothers and fathers who adhered more strongly to Storm and Stress beliefs about adolescence were more likely to exhibit higher levels of parental burnout. These associations were partially mediated by parental overprotection for both mothers and fathers. The strength of these pathways were found to be similar for both mothers and fathers and no partner effect was observed. These results suggest that countering negative beliefs about adolescence may be beneficial for the quality of parenting and the experience of being a parent.

Internalizing and externalizing correlates of parental overprotection as measured by the EMBU: A systematic review and meta-analysis.

Aspects of parenting including overprotection explain individual differences in child adjustment. This review and meta-analysis summarizes studies on parental overprotection and internalizing and externalizing problems. To ensure that findings could be compared as systematically as possible, the focus was on studies that used the overprotection scale of the Egna Minnen Beträffande Uppfostran ("Memories of my Parents' Upbringing") (EMBU) questionnaire, a popular instrument to measure parental overprotection. In total, we extracted 176 effects from 29 studies. A modified version of the Newcastle-Ottawa Scale was used to perform quality assessments for the included studies. Parental overprotection was associated positively with offspring internalizing and externalizing problems, with overall estimates ranging from r=.14 to .18. Moderator analyses suggested that effects of maternal were larger than effects of paternal overprotection. Other factors that moderated the strength of the association between overprotection and maladjustment included whether outcomes were self-reported or parent-reported, the design was cross-sectional or longitudinal, and publication year. Cultural context, age at exposure, and child sex did not explain differences between effect sizes. Most findings were based on cross-sectional studies and therefore do not constitute proof of causal relations. Many studies were of less-than-satisfactory quality regarding representativeness of the sample, descriptions of the data collection, and statistical analyses. There is a clear need for well-powered longitudinal studies to strengthen inferences about associations between parental overprotection and internalizing and externalizing problems.

Maternal respiratory sinus arrhythmia contextualizes the relation between maternal anxiety and overprotective parenting.

This current study examined maternal characteristics that predict the use of overprotective parenting in mothers of toddlers. Maternal respiratory sinus arrhythmia (RSA) reactivity was tested as a moderator of the relation between maternal anxiety and overprotective parentig. Mothers (n = 151) and their 2-year-old toddlers participated in a laboratory visit and returned for a follow-up visit 1 year later. At child age 2, mothers reported their own anxiety. Mothers' RSA reactivity was measured between a resting baseline and a standardized laboratory task, and overprotective parenting was observed in that task. Toddler fearful temperament (FT) was observed in a separate standardized task as well as reported by mothers. At child age 3, mothers' overprotective parenting behaviors were observed according to the same procedures so change from age 2 could be measured. Results revealed that maternal anxiety and maternal RSA at age 2 interacted to predict relative increases in overprotective parenting behaviors at age 3. At low levels of RSA reactivity, reflecting RSA suppression, maternal anxiety predicted lower levels of overprotective parenting. At high levels of RSA reactivity, reflecting RSA augmentation, maternal anxiety predicted higher levels of overprotective parenting. Our results suggest that RSA suppression may protect mothers with anxiety symptoms from engaging in overprotective parenting, whereas RSA augmentation may put mothers with anxiety symptoms at risk for engaging in overprotective parenting. Findings indicate that the interaction of multiple parental traits should be considered when working with parents and families on parenting behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of parental care and overprotection on adolescents' diurnal cortisol profiles

Parental bonding is a strong determinant of children's health. One of the proposed pathways through which parenting impacts children's health is by altering the functioning of stress response systems. The current study aims to investigate the associations between two types of parental bonding (care and overprotection) and functioning of hypothalamic-pituitary-adrenal (HPA) axis (i.e., diurnal cortisol secretion) in a sample of 255 healthy adolescents (46.3% girls; aged 11–14 years). Participants completed the Parental Bonding Instrument and provided eight cortisol samples across two consecutive days to assess patterns of diurnal cortisol secretion. Multilevel modeling and multiple linear regression were utilized to test the main effects and interactive effects of parental care and overprotection on adolescents' wakeup cortisol, cortisol awakening response, cortisol slope, and total cortisol secretion. Results showed that parental care was associated with higher cortisol levels at awakening, while parental overprotection was associated with lower cortisol levels at awakening. Parental overprotection, but not parental care, was associated with flatter cortisol slopes. No interactive effects between parental care and overprotection on cortisol parameters emerged. The current findings add to the existing literature on parenting behavior and HPA functioning by showing that parental care and overprotection differently regulated daily cortisol parameters implicated in health.

Ehlers-Danlos Syndrome in the Field of Psychiatry: A Review.

Ehlers-Danlos syndrome (EDS) comprises a series of rare hereditary connective tissue diseases characterized by joint hypermobility, joint dislocation, and hyperextensibility of the skin, as well as cardiovascular involvement. EDS is often associated with chronic widespread physical pain, which can lead to psychological pain. Poor awareness and limited diagnosis of EDS and related symptoms result in decreased self-esteem and confusion regarding physical sensation. Furthermore, EDS imposes substantial psychological burden on patients due to exercise restriction, scars, keloids, and subcutaneous fat accumulation on the extremities, which leads to parental overprotection and bullying experiences from other children at school age. Recent large-scale studies have suggested that patients with EDS have a higher risk of mood disorders than the general population. Other cohort studies indicated high prevalence of anorexia nervosa, addiction, obsessive compulsive disorder, and anxiety disorder were found in patients with EDS. Case reports instead indicated that some psychiatric disorders were secondary symptoms due to physical problems from EDS. Therefore, psychiatrists must be more knowledgeable and proactive about EDS in their practice. We review the previous case reports and literature for patients with EDS, along with our own case of complicated psychiatric problems, which are strongly related to early stressful situations through childhood and adolescence. This is to aid general psychiatrists in the discussion of appropriate medical management in such infrequent, yet challenging conditions.