Parental Rejecting Behaviors: Validating a Behaviorally Based Youth-Report Measure of Parental Emotional Abuse

Abstract

Positive and warm parental attitudes are associated with better social and emotional child functioning, whereas negative or rejecting parental attitudes are associated with poor outcomes, such as aggression, impaired self-esteem, and emotional instability. The current study investigated the reliability and validity of scores on an interview adaptation of a measure of parental rejecting behavior (PRB) in a sample of detained adolescents. Participants (N = 198) completed a measure assessing their memories of the frequency of specific parental behaviors associated with rejection and self-report measures of exposure to abuse/neglect and community violence, and internalizing and externalizing psychopathology. PRB scores were internally consistent and associated with several kinds of child maltreatment. PRB scores correlated uniquely with indices of internalizing and externalizing symptomatology, even after controlling for indices of overall child maltreatment or a specific index of emotional abuse. The pattern of correlations suggests that the measure provides a valid index of parental emotional abuse, which may help identify youth at risk for both internalizing and externalizing disorders.

Keywords

child abuse emotional abuse rejection parenting internalizing externalizing

Several theoretical perspectives highlight the importance of parent–child relationships on child development (e.g., Ainsworth et al., 1978; Bronfenbrenner & Morris, 1998; Garber & Dodge, 1991; Garcia Coll, 1990; Lutz et al., 2009; Schlomer et al., 2011). These perspectives suggest that primary caregivers serve a critical role in the formation of a child’s personality. Consistent with these perspectives, numerous studies have identified relations between specific attributes, behaviors, and attitudes of caregivers or attributes of the parent–child relationship and children’s psychosocial functioning and psychopathology (e.g., Curran et al., 2005; Flouri &Buchanan, 2002; Mills-Koonce et al., 2018; Stafford et al., 2016). Below, we summarize evidence suggesting that hostility and rejecting attitudes in caregivers may contribute to the development of psychopathology. Because few studies have examined the impact of parental rejection and hostile attitudes after controlling for individual differences in maltreatment, this study¹ was designed to examine the unique contribution of this construct to subsequent psychopathology. We addressed the utility of an interview measure for assessing adolescent-reported memories of the frequencies of specific parental behaviors associated with maltreatment to measure underlying parental antipathy. In particular, we examined whether adolescents’ self-reported ratings of the frequencies of behaviors associated with hostile and rejecting parental attitudes were linked with internalizing and externalizing psychopathology in a sample of incarcerated adolescents. We also examined whether such attitudes were uniquely associated with psychopathology after controlling for overall levels of childhood maltreatment, and even after controlling for other adolescent-reported experiences of emotional abuse.

Several distinct aspects of parenting have been described as protective factors, positively impacting psychological development and social/emotional functioning. Authoritative, inductive, and consistent parenting styles are associated with better psychosocial outcomes for youth (Nair & Murray, 2005). In addition, parental warmth, involvement, responsiveness to child characteristics and parental monitoring (Kerr et al., 2009) are all associated with better interpersonal and cognitive functioning in childhood and adolescence (Estrada et al., 1987; Suchman et al., 2007; Supplee et al., 2007; Watson et al., 2014).

Conversely, several parenting styles and strategies are considered risk factors for developmental psychopathology. For instance, authoritarian, coercive, insensitive, and inconsistent parenting styles have been linked with externalizing psychopathology (Booth-LaForce & Oxford, 2008; Viding et al., 2009). There is also substantial evidence linking child abuse and neglect to poor outcomes. Several researchers have explicitly identified parental antipathy or emotional abuse as a set of parental attitudes and behaviors reflecting hostility, coldness, or rejection directed toward the child (Bifulco et al., 2005). To the extent that parental rejection and hostility negatively interfere with a child’s sense of security, quality of attachment, and development of self-esteem, they may have direct effects that extend beyond the impact of abuse and neglect. In this report, we use the term antipathy to convey the full constellation of rejecting attitudes and behaviors, hostile attitudes, and a variety of forms of overt and covert abuse and maltreatment, but our chief focus is whether the assessment of specific adolescent-reported parental rejecting behaviors (PRBs) provides a useful index of underlying parental antipathy, and whether such antipathy has an impact beyond what can be assessed based on reports of abuse and maltreatment. Because there have been many more studies of the impact of abuse and neglect than of parental hostility or rejecting attitudes toward children, we review the evidence about the relation between child maltreatment and psychopathology before addressing more specific studies of hostile attitudes and specific behaviors.

The Impact of Child Physical Abuse and Sexual Abuse

The harmful effects of physical abuse on children have been well documented. Youth with histories of physical abuse experience a greater number of personal, family, and school problems than those without abuse histories (Ferguson, 2009). Additionally, a history of physical abuse is a risk factor for suicide attempts and for a variety of mental health problems, including depression, conduct disorder (CD), and trauma symptoms (Berzenski & Yates, 2011; Ferguson, 2009; Masako, 2011). Furthermore, several studies have demonstrated that physical maltreatment prospectively predicted antisocial behavior (Jaffee et al., 2004; Sousa et al., 2011).

The harmful impact of sexual abuse is also widely recognized. Negative outcomes associated with childhood sexual abuse include internalizing symptoms such as depression, anxiety, posttraumatic stress disorder, self-harm behaviors, and low self-esteem (Kendall-Tackett et al., 1993; Paolucci et al., 2001). Conduct problems, aggressive behaviors, substance misuse, and maladaptive sexual behaviors represent externalizing psychopathology outcomes associated with childhood sexual abuse (Paolucci et al., 2001; see also a meta-analysis by Dworkin et al., 2017).

The Impact of Child Neglect

Although physical and emotional neglect may be the most prevalent form of child maltreatment, they are considered more difficult to identify than physical and emotional abuse because neglect involves the absence of specific kinds of behaviors and interactions rather than the presence of overt behaviors (Chalk et al., 2002; Dunn et al., 2002; Schumacher et al., 2001). The developmental consequences of neglect appear to be as severe as or even more severe than those related to physical abuse and sexual abuse (e.g., Hart et al., 1998; Trickett & McBride-Chang, 1995; Young et al., 2011). Children with histories of neglect are at elevated risk for deficits in socioemotional and cognitive functioning as well as both internalizing and externalizing problems (Bailey et al., 2009; Hildyard & Wolfe, 2002; Kim & Cicchetti, 2010; Knutson et al., 2004; Lee & Hoaken, 2007; Shields & Cicchetti, 1998). Moreover, prospective, longitudinal studies have suggested that neglect predicts the development of personality pathology (Johnson et al., 2000).

The Impact of Child Emotional Abuse

Ample evidence links emotional abuse to a wide range of negative consequences for children. Emotional abuse is commonly characterized as verbal hostility, belittling, humiliation, and sometimes as rejection by the parent; such a definition suggests that the emotional abuse includes harmful attitudes as well as emotionally abusive behaviors themselves (Egeland, 2009; Paavilainen & Tarkka, 2003). Emotionally abused children tend to appear socially withdrawn and exhibit less social competence in adolescence (Berzenski & Yates, 2011; Egeland, 2009). In addition, childhood emotional abuse is associated with high rates of dissociation, anxiety, depressive symptoms, and lower levels of self-esteem and school achievement (Egeland, 2009; Solomon, & Serres, 1999).

Perspectives on the Distinctiveness of Parental Rejection

Although negative parenting is generally associated with problematic developmental outcomes, there are two distinct perspectives on the impact of different forms of abuse and neglect. Several studies suggest that distinct forms of maltreatment are associated with different consequences (Egeland et al., 1983; Valentino et al., 2011). For example, physical maltreatment has a stronger association with externalizing psychopathology than with internalizing psychopathology, whereas sexual abuse is especially associated with later dysfunction in sexual relationships (Berzenski & Yates, 2011; Briere & Runtz, 1990). Similarly, emotional abuse has been more strongly linked to internalizing psychopathology (Berzenski & Yates, 2011). From this perspective, parental rejection may be conceptualized as a form of emotional abuse, that is, separate from other forms of abuse and neglect or as a set of parental attitudes that may be harmful even if they do not always constitute child maltreatment per se. In fact, it is plausible that the impact of parental rejection may even be distinct from the impact of general emotional abuse and other specific forms of emotional abuse (e.g., exploitation, relational aggression, and shaming).

We note, however, that in the present study, our chief interest in assessing PRBs was to identify individual differences in underlying parental antipathy that might not be fully captured by previously validated measures of maltreatment. More precisely, we wished to examine whether a measure that only required participants to estimate the frequency of specific experiences might yield reliable estimates of the severity of hostile and rejecting attitudes. Assessing subjective estimates of specific behaviors instead of global or abstract labels might yield different information than is obtained by traditional self-report measures of maltreatment. For example, a subjective recall-focused measure might activate fewer of the emotional responses typically aroused by direct questions about feelings and attitudes. Alternatively, assessing the frequency of specific behaviors might make it easier for adolescents to identify parental actions that are informative about underlying rejecting attitudes and hostility, or, more broadly, antipathy. Consequently, any evidence of unique associations between scores on the current measure and external criteria could reflect the value of assessing parental rejection or could simply reflect the value of the current method of measuring parental antipathy by assessing adolescents’ memories of specific parental behaviors.

Alternatively, several researchers have argued that it is difficult to distinguish the impact of different forms of abuse and neglect (e.g., Vachon et al., 2015). One argument for similar impacts of different forms of abuse is that many maltreated children are exposed to multiple forms of maltreatment (Bromfield et al., 2007). In addition, the impact of specific traumatic events depends on the family environment in which it occurs, and maltreatment commonly occurs in family contexts characterized by frequent negative interactions, negative attitudes, and the absence of appropriate parental supervision and care (Higgins, 2004). Because contexts characterized by hostility/rejection commonly co-occur with various forms of abuse, and emotional abuse is especially likely to occur in such contexts, it could be argued that the harmful effects of hostile and rejecting behaviors are largely the same as the harmful effects of emotional abuse in general (Erkman, 1992; Rohner et al., 2005). Only studies that directly assess specific rejecting behaviors and measures of overt abuse and neglect together can examine whether these kinds of experiences are related to similar or distinct consequences.

Research Assessing the Impact of Parental Rejection, Hostility, and Emotional Abuse

Experiences of parental rejection and hostility have sometimes been operationalized using objective observations of a child’s experiences (the behavioral perspective) and sometimes by assessing a child’s subjective perception of parental rejection and hostility (the phenomenological perspective; Rohner et al., 2005). Consistent with the behavioral perspective, studies have demonstrated relations between both parent reports and other reports of parental hostility or rejection and the development of childhood psychopathology, including depression (McLeod, Weisz, et al., 2007) and anxiety (McLeod, Wood, et al., 2007; see also Sentse et al., 2010). Moreover, in a meta-analysis, McLeod, Weisz, et al. (2007) noted that parental rejection was an especially strong predictor of child depression but only in multiple-informant studies, suggesting that it may not be easy to assess rejection using only parent reports or only child reports. Caspi et al. (2004) examined the longitudinal impact of mother-reported maternal negative attitudes on the development of conduct problems in their children. They found that, within twin pairs, the twin experiencing greater maternal negative emotion at age 5 exhibited greater conduct problems 18 months later.

One limitation of studies that have operationalized parental rejection using parent or other reports of rejection has been that observers may sometimes report significant parental abuse or neglect when a child does not appear to feel rejected (Rohner et al., 2005). Conversely, a child may feel unloved, but an observer may fail to detect parental rejection. Rohner (2004) argued that, where objective and subjective reports differ, subjective reports are likely to be more sensitive. Based on increased interest in children’s subjective perceptions, much of the research on parental antipathy has focused on children’s perceptions of parenting style (Yahav, 2006). Studies have demonstrated that children’s perceptions of parental rejection are related to symptoms of internalizing psychopathology, including anxiety (Grüner et al., 1999; McLeod, Wood, et al., 2007) and depression (McLeod, Weisz, et al., 2007; Oliver & Whiffen, 2003). Both qualitative and meta-analytic reviews of the literature on child perceived acceptance-rejection suggest that perceived parental rejection may be associated with a specific syndrome of psychological maladjustment, including impaired self-esteem, emotional instability, negative worldview, and hostility (Buschgens et al., 2010; Khaleque & Rohner, 2002; see also Rohner, 2004).

Phenomenological measures of parental rejection also have, however, their limitations. Individuals’ self-reports and perceptions of their own and others’ behaviors can be either positively (Gosling et al., 1998) or negatively biased as a function of the kinds of disorders commonly associated with parental hostility and child maltreatment (e.g., Epkins & Harper, 2016). In addition, agreement between self and others is especially poor in global judgments of traits, including personality traits (e.g., warmth, hostility; Funder & Colvin, 1997) and personality pathology, individual differences in coping strategy and mind-set, and participation in treatment programs can influence such judgments (F. M. Gagné et al., 2003; C. T. Taylor et al., 2011).

Another set of difficulties in assessing children’s and adolescents’ reports of parental rejection and hostility is that youth, like adults, may be reluctant to report experiences that are often stigmatized (including parental rejection). A related issue is that youth may be reluctant to appraise some abusive behaviors as abusive. More generally, many of us appear to have difficulty or resistance to acknowledging or applying portentous labels to aversive experiences. As a result, individuals may sometimes underreport histories of bad experiences generally and may be especially likely to underreport experiences that require them to integrate across experiences to make general judgments or that require inferences about another person’s motives or evaluations of the severity of a behavior. For example, studies show that more women and men report being coerced into sexual activity than report being raped (e.g., Artime et al., 2014; McMullin & White, 2007). Men are more willing to report committing coercive sexual behavior than they are willing to report that they committed rape (e.g., Edwards et al., 2014; Koss,1998). These studies suggest that people may be more willing to acknowledge having specific experiences or committing particular behaviors when they are presented with concrete behavioral descriptors that do not convey affectively charged labels. Similarly, rating systems that focus on concrete behaviors and avoid global judgments may be more effective at reducing rater bias (J. R. Gagné et al., 2011). For these reasons, we wanted to examine whether a measure of specific behaviors indicative of parental rejection and hostility would have incremental value in evaluating the impact of maltreatment.

Because most prior studies of parental hostility and emotional abuse have not concurrently examined the impact of abuse and neglect, it is sometimes not clear whether relations between emotional abuse and social/emotional impairments reflect unique effects of parental antipathy, including rejecting and hostile attitudes, or whether indices of PRBs are simply another method of assessing abuse and neglect. Kingston et al. (2016) addressed this issue in a retrospective study of adult offenders. They examined participants’ ratings of the frequency of specific parental behaviors in the context of participants’ ratings of other abusive experiences. They found that, after controlling for physical and sexual abuse, ratings of paternal rejecting behaviors, especially male caregiver rejecting behaviors (which they called Psychological Abuse), uniquely predicted subsequent hyper sexuality. Davis and Knight (2019) replicated these findings in a sample of juveniles who had sexually offended (see also Daversa & Knight, 2007). These studies suggest that the frequency of PRBs could be a distinct attribute of the parent–child relationship with distinct correlates. It remains possible, however, that rejecting and hostile parenting styles reflect a form of emotional abuse associated with internalizing and externalizing outcomes in a manner very similar to what is seen with other forms of emotional abuse (Shelton & Harold, 2008).

The Current Study

The current study was designed to examine the utility of an interview form of a brief measure of PRBs that appear to be indicative of rejecting parental attitudes. This measure was developed with the aim of providing a valid assessment of relatively pervasive and consistent parental hostility or antipathy by asking adolescents to identify the frequency of specific behaviors likely to reflect hostile or rejecting parental attitudes. The items were originally developed for use in the Multidimensional Assessment of Sex and Aggression (MASA, R. A. Knight & Cerce, 1999), subsequently renamed the Multidimensional Inventory of Development, Sex, and Aggression (MIDSA; 2011). They included concrete experiences and interactions with caregivers. The measure was constructed to incorporate both subjective and objective components, in that youth reports of event frequencies were expected to provide a measure of each individual`s subjective view of his or her perceptions of parental figures. At the same time, the focus on the frequency of categories of specific behaviors was expected to yield a more reliable estimate than either a focus on memories for emotional states or specific events or questions encouraging inferences about abstract parental attitudes (Buss & Craik, 1983).

Our first aim was to examine the reliability of these interview-based PRB scores as well as the convergent and discriminant validity of the scores. If the scale was a valid measure of parental antipathy toward a child, scores on the PRB should appear internally consistent and correlate negatively with measures of parental warmth and affection, but positively with indices of child abuse and neglect within the home. Because childhood abuse and neglect are commonly associated with risk of exposure to community violence, we also expected that PRB scores would correlate with indices of exposure to community violence.

In addition, to the extent that PRB scores are valid measures of parental antipathy, they should be associated with indices of several forms of psychopathology. Concretely, this index of parental rejection was expected to correlate with indices of both internalizing psychopathology (e.g., depression and anxiety) and externalizing psychopathology (e.g., CD symptoms, number of criminal charges, and substance abuse). We also hypothesized that PRB scores would show discriminant validity and would not correlate significantly with demographic indices such as age, ethnicity, and general intellectual functioning.

The second aim of the study was to examine whether PRB is uniquely associated with psychopathology in adolescent offenders, above and beyond the predictive ability of childhood maltreatment. We first examined whether PRB scores were uniquely associated with indices of internalizing and externalizing psychopathology after controlling for overall levels of childhood maltreatment. Then, to provide a more stringent test of the utility of the measure, we evaluated whether PRB scores were uniquely related to psychopathology even after controlling for a specific index of emotional abuse. We also examined the possibility of PRB X Childhood maltreatment interactions. Evidence that PRB scores contribute uniquely to the prediction of psychopathology would suggest that its focus on specific behaviors that express rejection distinguishes it from other measures of emotional abuse that measure a diverse range of manifestations of emotional abuse (including subjective experiences of rejection).

These hypotheses can be summarized as follows:

Hypothesis 1a: PRB scores will correlate negatively with an index of parental warmth and affection but positively with indices of child abuse and neglect within the home.

Hypothesis 1b: PRB scores will correlate positively with indices of exposure to community violence.

Hypothesis 2: PRB scores will correlate positively with indices of both internalizing and externalizing psycho-pathology.

Hypothesis 3: PRB scores will not correlate with age, ethnicity, or an index of general intellectual functioning.

Hypothesis 4a: PRB scores will be uniquely associated with internalizing and externalizing psychopathology after controlling for overall levels of self-reported child maltreatment.

Hypothesis 4b: PRB scores will be uniquely associated with internalizing and externalizing psychopathology after controlling for self-reported emotional abuse.

Method

In this section, we report how we determined our sample size, all data exclusions, all manipulations, and all measures in the study.

Participants

Participants were 198 incarcerated adolescents at an Illinois detention center who assented and whose parents or other familial guardians consented for them to participate and who completed measures. All participants’ data were retained for analyses if their Childhood Trauma Questionnaire (CTQ) validity scale score indicated a valid profile (see Measures of Childhood Abuse, Neglect, and Trauma section). One hundred seventy four of the participants were male, and the other 25, female. The sample was 33.3% (n = 66) Latino, 30.3% (n = 60) European American, 27.3% (n = 54) African American, with 8.1% reporting biracial or multiracial ethnicity (n = 16) and 1.0% (n = 2) reporting no ethnicity information.

Measures of PRBs

Parental Rejecting Behavior Scale

The PRB Scale is an interview adaptation of a self-report measure originally designed to assess parental hostile control and rejection in the final version of the MASA (R. A. Knight & Cerce, 1999; now called MIDSA (2011). The scale was originally generated from a factor analysis of a larger set of items selected to assess child ratings of caregiver behavior calculated on a large sample of adults convicted of sexual offenses. Confirmatory factor analyses in both a sample of juveniles who had committed sexual offenses and an adult male community sample indicated good fit for a two-factor model (MIDSA, 2011). The two factors were originally labelled Emotional Abuse and Acceptance Neglect (discussed next).² Internal consistencies for the Emotional Abuse scale were reportedly above .90 in all samples.

On each item, participants indicated the frequency of concrete, specific parental behaviors (e.g., How often did your parent tell you they did not love you?). See Table 1 for full scale. In contrast to the MASA/MIDSA, where the scale is administered on a computer as part of a Comprehensive Developmental Inventory, in the present study, the PRB was administered in an interview format with a 5-point Likert-type scale on which answers ranged from never (1) to very often (5). Participants were allowed to indicate their answers in words or by identifying the number associated with the different frequencies. As discussed below, preliminary analyses assessing corrected item-to-total correlations led to retention of all 10 items in the PRB scale. Total scores were computed on the basis of a simple summation of scores across items. Inspection of item scores showed that scores on all 10 items ranged from 1 to 5, suggesting adequate variability for all items.

Table 1.

Corrected Item-Total Correlations (r_its₎ for Parental Rejecting Behaviors Items.

Item	r _it
1. How often would you say a parent had temper tantrums or fits before you were 17?	.44
2. How often did a parent act really mean before you were 17?	.51
3. How often did a parent tell you that they wished you were never born before you were 17?	.48
4. How often did a parent say that she did not love you before you were 17?	.38
5. How often did a parent ignore you when you wanted them to pay attention to you before you were 17?	.52
6. How often did a parent call you “no good” or something similar before you were 17?	.58
7. How often did a parent yell at you before you were 17?	.57
8. How often did a parent use swear words with you before you were 17?	.56
9. How often did a parent threaten you with a weapon before you were 17?	.43
10. How often did a parent threaten to throw you out of the house before you were 17?	.52

Parental Acceptance Neglect Scale (PAN; MIDSA, 2011)

The eight-item scale MASA/MIDSA Acceptance Neglect scale, which measures parental caring and warmth versus neglect was also administered in an interview format with a 5-point Likert-type scale ranging from never (1) to very often (5). These items were also adapted from the MASA/MIDSA (R. A. Knight & Cerce, 1999; MIDSA, 2011) and were administered prior to the PRB items. The scale was originally generated by the same factor analyses that were described earlier for PRB. Internal consistencies for the MIDSA Acceptance Neglect scale were all >.9 in all samples. The internal consistency of scores on the PAN in the present sample was acceptable (α = .84; mean interitem r = .41). Corrected item-to-total correlations ranged from .31 to .69.

Measures of Childhood Abuse, Neglect, and Trauma

Childhood Trauma Questionnaire–Short Form (CTQ-SF; Bernstein & Fink, 1998; Bernstein et al., 2003)

The CTQ-SF is a 28-item self-administered inventory designed to provide a reliable and valid retrospective index of child abuse and neglect based on the original 70-item CTQ (Bernstein, Fink, Handelsman, & Foote, 1994). Items ask about experiences in childhood and adolescence and are rated on a 5-point Likert-type scale with response options ranging from never true to very often true. The CTQ-SF has five clinical scales that assess physical, emotional and sexual abuse, and emotional and physical neglect, as well as a minimization/denial validity scale. Participants who scored below 3 on the CTQ Minimization/Denial validity scale were included in analyses. For the present study, the CTQ total score and subscale scores were obtained by computing simple sums of unweighted item scores. Because two of the five items on the CTQ emotional abuse subscale appeared to overlap with item content on the PRB Scale (i.e., “people in my family called me things like ‘stupid,’ ‘lazy,’ or ‘ugly’ and ‘people in my family said hurtful or insulting things’”) scores on these two items were removed, and a prorated emotional abuse subscale score was used in principal analyses to minimize predictor-criterion contamination. Findings for this modified emotional abuse subscale score were very similar to findings using the original score. Scores on the CTQ are reported to exhibit excellent stability. Subscale scores correlate with expected criteria and correlate moderately with scores on the Childhood Trauma Interview (Bernstein et al., 2003). In this sample, both the original Emotional Abuse scale (α = .79) and modified CTQ Emotional Abuse scale (α = .69) yielded acceptable internal consistency, and scores on the two scales were highly correlated, r(196) = .93, p < .001. Square root transformations were applied to correct skewness in the modified emotional abuse scores after winsorizing extreme scores. Log transformations were applied to correct skewness in the Emotional Neglect and Physical Neglect scale scores, and inverse transformations were applied to CTQ physical abuse scores. Because no transformations eliminated skewness in CTQ sexual abuse and overall maltreatment scores, we estimated generalized linear models (GLiMs) to examine the impact of PRBs on self-reported sexual abuse and overall self-reported maltreatment.

Community Experiences Questionnaire (CEQ; Schwartz & Proctor, 2000)

The CEQ is a 25-item self-report measure of exposure to violence in the community, which yields both total and subscale scores for direct victimization and for witnessing violence. Items range in severity from threats of violence to shootings, and the frequency of each experience is rated on a 4-point Likert-type scale ranging from never to a lot of times. Participants were instructed to exclude incidents involving family members and other individuals living at home and to refer only to real-life events rather than movies and television. Prior studies demonstrate that CEQ scores provide reliable and valid indices of exposure to community violence (Schwartz & Gorman, 2003; Schwartz & Proctor, 2000). Analyses indicated good internal consistency for the victimization (α = .84) and witnessing (α = .83) scales, as well as for CEQ total scores (α = .89), and there were large correlations between the subscale scores, r(196) = .70, p < .001. Square root and log transformations were used to correct skewness in CEQ total and witnessing subscale scores, respectively.

Measures of Internalizing Psychopathology

Childhood Depression Inventory (CDI; Kovacs, 1992)

The CDI is a 27-item self-report inventory assessing affective, motivational, cognitive, and vegetative symptoms of depression. The scale was designed to identify youth with major depressive or dysthymic disorder, and CDI scores are sensitive to change over time. Responses to each item are classified as indicating no symptom, a mild symptom, or a definite symptom. Total scores exhibit good internal consistency and correlate strongly with scores on other measures of depression (D. Knight et al., 1988). A square root transformation corrected the skewness of CDI scores.

Taylor Manifest Anxiety Scale (TMAS; J. A. Taylor, 1953)

The TMAS is a 50-item true/false self-report measure developed to assess trait anxiety. Scores on the TMAS are internally consistent (α = .83) and stable over 3 weeks, 5 months, and 9 to 17 months (rs = .89, .82, and .81, respectively; Tanaka-Matsumi & Kameoka, 1986). TMAS scores have also been found to correlate highly with scores on other measures of anxiety, and moderately with Beck Depression Inventory scores (Zung, 1974). The score distribution revealed that skewness was not significant using conservative criteria (Skewness statistic = 2.27, p > .01).

Measures of Externalizing Psychopathology

Symptoms of Conduct Disorder (CD; American Psychiatric Association, 1994)

The interviewer assessed the total number of symptoms of childhood CD for which each participant met DSM-IV criteria (number of CD symptoms before age 18). CD symptoms include both nonviolent offenses and violations of rules (e.g., stealing items of nontrivial value) as well as violent behaviors (e.g., frequently initiating fights or bullying others). Observer ratings in this sample were available for 41 cases. Interviewer and observer ratings of total number of CD symptoms before age 18 were strongly correlated, intraclass r(196) = .87, p < .001.

Criminal Behavior

Based on interview and institutional files, the number of violent and nonviolent charges and criminal versatility (i.e., the number of types of offenses committed) were rated. For this study, violent offenses included assault, murder, sexual assault, weapon charges, arson, and kidnapping, and nonviolent offenses included driving offenses, drug-related charges, fraud, obstruction of justice, and miscellaneous petty crimes. Square root and log transformations were used to correct skewness in the number of charges for violent and nonviolent crimes, respectively.

AIDS Risk Behavior Assessment (ARBA; Teplin et al., 2005)

The ARBA was derived from four well-established measures of sexual behavior and drug/alcohol use to assess adolescents’ self-reported behaviors related to risk for HIV infection, including sexual behavior (lifetime sexual intercourse, frequency, and high-risk sexual behavior), drug/alcohol use (lifetime use, method of use, and frequency), and needle use (sharing, tattooing, and piercing) over the lifetime as well as over the previous 6 months and a year (Donenberg et al., 2001). In this study, we examined the number of times participants used marijuana, alcohol, and hard drugs (i.e., cocaine, crack, heroin, other opioids, psychedelics, ice, other amphetamines, barbiturates, other tranquilizers, and combinations of drugs with opiates) across their lifetimes. Log transformations corrected skewness in indices of marijuana and alcohol use. Because no transformations corrected skewness in use of hard drugs, GLiMs were estimated to examine relations between PRB and lifetime hard drug use. Where analyses with transformed versus untransformed scores yielded different findings, both are summarized (correlational differences are summarized in text; regression differences, in Footnotes 3 and 4).

Demographic Variables

Age in years was obtained from files. Participants’ intelligence was estimated using the Wechsler Intelligence Scale for Children, Fourth Edition (WISC) vocabulary and block design subtests. Participants’ scores on these tests were used to generate a full-scale WISC IQ estimate. Whereas there was no significant skewness in IQ scores (Skewness statistic = -1.28, p > .05)., all transformations worsened the skewness in age scores. Consequently, GLiMs were estimated to examine relations between PRB scores and age.

Procedure

During visitation hours, we provided adolescents and parents/legal guardians with information about the study and the risks and benefits of participation, and we obtained participants’ assent and a parent’s/guardian’s consent. Trained graduate students administered all measures and read items to participants exhibiting reading difficulty. The PW and PRB scales were always administered as part of a larger interview assessing educational history, family history, relationships, hobbies, and antisocial behavior. All procedures were approved by the Rosalind Franklin University of Medicine and Science Institutional Review Board.

Data Analysis

For most dependent variables, zero-order and partial correlations were computed to examine associations and unique associations. To examine whether PRB scores were uniquely associated with psychopathology after controlling for overall child maltreatment or specific exposure to emotional abuse, we conducted two kinds of hierarchical regressions for most criteria: (a) regressions in which PRB scores were entered in the same step as CTQ total scores and (b) regressions in which PRB scores were entered in the same step as modified CTQ emotional abuse scores. In both kinds of regressions, the interaction between PRB scores and scores on the relevant index of maltreatment was entered in the second step of the regression. The sole exceptions were that GLiMs were estimated for variables for which neither untransformed nor transformed scores eliminated skewness: sexual abuse, overall maltreatment, lifetime use of hard drugs, and age. In such cases, the Vuong test was used to identify the model that best reflected the distribution of the dependent variable and the link between the dependent variable and the predictor(s).

Results

Mean scores of participants on all sample measures are shown in Table 2.

Table 2.

Descriptive Statistics for Current Sample.

Measure	M	SD	Range	Skewness
Age	15.42	1.07	11-17	−4.46***
WISC IQ estimate	87.66	15.16	51-123	−1.28
Parental rejecting behaviors	10.40	6.30	0-38	6.16
Parental warmth behaviors	24.29	6.17	2-32	−6.24***
Childhood Trauma Questionnaire (CTQ)	45.77	10.66	31-91	6.24***
CTQ Physical Abuse	8.15	4.32	5-37	14.65***
CTQ Sexual Abuse	5.95	2.96	4-25	25.18***
Modified CTQ Emotional Abuse	7.96	2.50	5-15.20	7.65***
Physical Neglect	7.90	2.85	5-16	4.47***
Emotional Neglect	10.25	4.59	5-24	6.12***
Community Experiences Questionnaire (CEQ)	59.14	18.63	0-176	6.38***
CEQ victimization	23.46	6.56	13-40	1.50
CEQ witnessing	37.15	12.11	16-139	17.75***
Childhood Depression Inventory	9.92	6.56	0-32	4.74***
Taylor Manifest Anxiety scale	18.54	7.67	4-40	2.34
Number of conduct disorder symptoms	5.70	2.60	0-12	1.25
Number of charges for violent crimes	1.99	2.46	0-17	14.46***
Number of charges for nonviolent crimes	2.94	4.76	0-38	25.03***
Number of times using alcohol	76.00	213.39	0-2290	46.57***
Number of times using marijuana	592.27	3940.02	0-3940	13.03***
Number of times using hard drugs	2.93	12.84	0-115	12.43***
Proportion European American, % (n)	30.15 (60)
Proportion African American, % (n)	27.14 (54)
Proportion Latino American, % (n)	33.67 (67)
Proportion biracial/multiracial, % (n)	8.04 (16)

Note. N = 198 (174 males and 25 females). WISC = Wechsler Intelligence Scale for Children, Fourth Edition. No ethnicity information was available for 1.01% of the sample (n = 2). WISC IQ estimate is the WISC intelligence quotient as estimated from Vocabulary and Block Design subtest scores.

***

p < .001.

Reliability of PRB Scores

The requirement that each item correlate .30 with the corrected score for the measure as a whole (Nunnally, 1978) led to retention of all 10 items (see Table 1). The internal consistency of the 10 items in the final measure was adequate (α = .81; standardized item-value = .82). The mean interitem correlation was .31 suggesting homogeneity of variance of the items.

Validity of PRB Scores

Validity analyses addressed three kinds of construct validity. Concurrent validity was assessed by examining the relation between PRB scores and an index of parental warmth and affection. Convergent validity included assessments of relations between PRB scores and indices of child maltreatment and exposure to violence scores, and indices of psychopathology. Discriminant validity analyses examined relations between PRB scores and demographic measures. A two-tailed alpha level of .05 was used to evaluate correlations and regressions; an alpha level of .01 was adopted for comparisons between dependent correlations.

Concurrent Validity

To the extent that parental expressions of warmth and affection reflect the opposite of hostility and coldness, scores on an index of parental actions reflecting hostility were expected to vary inversely with scores on an index of parental actions reflecting warmth. As expected, total PRB scores correlated negatively with total parental warmth ratings, r(196) = −.62, p < .001. The correlation was not so high, however, that it suggests the two measures are redundant.

Convergent Validity With Measures of Maltreatment and Exposure to Violence

Correlations indicated significant relations between ratings of parental rejection and self-reported traumatic childhood experiences both in and outside the home. As noted above, GLiMs were estimated to examine relations between self-reported overall maltreatment (and between sexual abuse) and PRB. In both cases, the negative binomial regression provided the best approach for modeling the data. For CTQ overall maltreatment scores, PRB scores were associated with a small but significant increase in the likelihood of overall childhood maltreatment (incidental risk ratio [IRR] = 1.04, p < .001, 99% confidence interval [CI: 1.03, 1.06]. Similarly, PRB scores were associated with a modest increase in the likelihood of self-reported sexual abuse (IRR = 1.04, p < .001, 95% CI [1.02, 1.06]).

PRB scores correlated positively with scores on all CTQ subscales examined via zero-order correlations, including the modified Emotional Abuse scale, r(196) = .50, p < .001, the Physical Abuse scale, r(196) = .34, p < .001,the Emotional Neglect scale, r(196) = .31, p < .001, and the Physical Neglect scale, r(196) = .18, p < .05. The correlation between PRB ratings and total CEQ scores was small but significant, r(193) = .16, p = .026, as was the correlation with CEQ Victimization subscale scores, r(183) = .22, p = .003; for CEQ Witnessing, r(181)= .10, p = .185.

Convergent Validity With Measures of Psychopathology

As predicted, PRB ratings correlated significantly with scores on both internalizing psychopathology measures examined. They correlated moderately with CDI total scores, r(194) = .35, p < .001, and more modestly with TMAS total scores, r(189) = .21, p = .003. In contrast, PRB scores correlated only with half of the indices of externalizing psychopathology examined. Scores on the PRB were positively correlated with symptoms of CD by age 18, r(171) = .25, p = .001. Positive correlations between PRB scores and lifetime alcohol use, r(194) = .20, p = .005 and lifetime marijuana use, r(193)= .16, p = .024, were also significant. In contrast, correlations were near zero for charges for violent and nonviolent offenses, rs(189)= .07, .01, ps > .360. A negative binomial regression indicated that PRB scores were also related to lifetime hard drug use, IRR = 1.21, 95% CI [1.03, 1.45], p < .001. The pattern of correlations for self-reported drug use was different for untransformed than for transformed scores. Using untransformed scores, PRB scores were uncorrelated with lifetime alcohol and marijuana use, rs(191, 190) = .01, ps > .850.

Assessing Whether PRBs Are Uniquely Related to Psychopathology

Multiple regressions examined whether PRB ratings correlated with indices of internalizing and externalizing psychopathology when controlling for exposure to violence in the home and specifically for the CTQ emotional abuse subscale score (see Table 3). In each regression, PRB total scores and either CTQ total scores or modified CTQ Emotional Abuse subscale scores were entered simultaneously. Except as noted explicitly, there were no significant interactions between PRB and either form of child maltreatment. The sole evidence for interactions between child maltreatment and PRBs appeared in analyses of lifetime alcohol use.

Table 3.

Correlations Between PRB Scores and Indices of Psychopathology.

	Internalizing psychopathology		Externalizing psychopathology
	CDI	TMAS	CD Sxs	ALC	MAR	VIO	NONVIO
Zero-order^a	.35***	.21**	.25**	.20**	.16*	.07	.01
Partial^b	.24**	.09	.22**	.18^d **	.16^d *	.07	.04
Partial^c	.16^e *	.04	.19*	.14^e *	.19^e **	.08**	.07

Note. CDI = Child Depression Inventory; TMAS = Taylor Manifest Anxiety scale; CD Sxs = conduct disorder symptoms before age 18; ALC = number of times consuming alcohol; MAR = number of times using marijuana; VIO = number of violent charges; NONVIO = number of nonviolent charges; PRB = Parental Rejecting Behavior. Square root transformations were used to correct skewness for depression scores and violent charges; log transformations were used to correct skewness in alcohol and marijuana use and nonviolent charges.

ns = 173 to 196. ^bControlling for overall Childhood Trauma Questionnaire (CTQ) scores; ns = 170 to 193. ^cControlling for modified CTQ emotional abuse scores; ns = 170 to 193. ^d The partial correlation for PRB scores was not significant using untransformed scores, for alcohol use, partial r = -.10, p = .182; for marijuana use, partial r = -.02, p = .838. ^eThe partial correlation for PRB scores was not significant using untransformed scores, for CDI scores, partial r = .13, p = .061; for alcohol use, partial r = -.05, p = .482; for marijuana use, partial r = .03, p = .683.

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

Unique relations with internalizing psychopathology

The regression for CDI total scores including CTQ total scores indicated unique relations between overall maltreatment and CDI total scores (β = .33, p < .001) and between PRB ratings and CDI total scores (β = .23, p = .001). Similarly, the regression including modified CTQ emotional abuse scores indicated that both CTQ emotional abuse scores (β = .34, p < .001) and PRB scores (β = .17, p = .025) were uniquely associated with depression scores. See Table 4 for additional details.

Table 4.

Relations Between Parental Rejecting Behaviors (PRBs) and Internalizing Psychopathology.

Step	Independent variables	CDI			TMAS
Step	Independent variables	Β	F	ΔR²	β	F	ΔR²
1	CTQ TOTAL	0.33***	26.35	.21***	0.33***	15.45	.14***
1	PRB	0.23**			0.09
2	CTQ × PRB	−0.69	2.34	.01	0.20	0.18	.00
1	CTQ-EA	0.34***	25.25	.21***	0.32***	12.94	.12**
1	PRB	0.17*			0.05
2	CTQ-EA × PRB	−0.68	3.63	.02	−0.26	0.46	.00

Note. CDI = Children’s Depression Inventory; PRB = parental rejecting behavior; TMAS = Taylor Manifest Anxiety scale; CTQ-TOTAL = total score on the Childhood Trauma Questionnaire; CTQ-EA = score on the modified CTQ Emotional Abuse scale (see text for additional details).

p ≤ .05. **p < .01. ***p < .001.

Conversely, a regression in which PRB scores and CTQ total scores predicted TMAS total scores revealed that only CTQ total scores were uniquely related to anxiety scores (β = .33, p < .001); PRB scores were not (β = .09, p = .210, see Table 4). Similarly, with modified CTQ emotional abuse scores in the model, CTQ emotional abuse scores (β = .32, p < .001) but not PRB scores (β = .05, p = .573), uniquely predicted TMAS total scores.

Unique relations with externalizing psychopathology

As shown in Table 5, simultaneous regressions including PRB scores and Total CTQ scores as predictors of CD symptoms before age 18 revealed a unique relation between PRB scores and total CD symptoms (β = .23, p = .004),but the relation between CTQ total scores and CD symptoms was not significant in this model (β = .08, p = .325). Similarly, the regression including PRB and CTQ modified emotional abuse scores demonstrated that PRB scores were uniquely related to CD symptoms (β = .22, p = .010), but emotional abuse scores were not (β = .06, p = .669).

Table 5.

Relations Between Parental Rejecting Behaviors (PRBs) and Externalizing Psychopathology.

Step	Independent variables	CD Sxs			Charges, violent offenses			Charges, nonviolent offenses
Step	Independent variables	β	F	ΔR²	β	F	ΔR²	β	F	ΔR²
1	CTQ TOTAL	.08	6.37	.07**	−.04	0.52	.01	−.10	0.77	.01
1	PRB	.23**			.08			.05
2	CTQ × PRB	.10	0.04	.00	0.17	0.10	.00	−.58	1.28	.01
1	CTQ-EA	.06	6.10	.07**	−.05	0.57	.01	−.13	1.11	.01
1	PRB	.22*			.09			.08
2	CTQ-EA × PRB	−.20	0.25	.00	.61	2.18	.01	−.54	1.71	.01
Step	Independent variables	Alcohol use^a			Marijuana use^b			Hard drug use
Step	Independent variables	β	F	ΔR²	β	F	ΔR²	IRR	95% CI
1	CTQ TOTAL	.02	4.04	.04*	−.02	2.63	.03	0.94	[0.86, 1.05]
1	PRB	.19*			.17*			1.28***	[1.06, 1.54]
2	CTQ TOTAL × PRB	−.99*	3.91	.02*	−.93	3.43	.02	1.00	[0.98, 1.01]
1	CTQ-EA	.07	4.37	.04*	−.11	3.45	.04*	0.97	[0.71, 1.38]
1	PRB	.16*			.22**			1.23**	[0.98, 1.56]
2	CTQ-EA × PRB	.19	2.21	.01	−.68	2.92	.02	0.99	[0.94, NA]

Note. CD = conduct disorder; CD Sxs = number of CD symptoms; CTQ TOTAL = total score on the Childhood Trauma Questionnaire; PRB = Parental Rejecting Behavior; CTQ-EA = score on the modified Childhood Trauma Questionnaire Emotional Abuse scale; IRR = incidence risk ratio (see text for additional details); CI = confidence interval; NA = not available. Substance use scores refer to self-reported lifetime use of each substance as measured by individual items on the AIDS Risk Behavior Assessment.

Analyses of lifetime alcohol use yielded some different findings when conducted with untransformed scores. Overall levels of maltreatment were uniquely related to alcohol use only for untransformed scores (β = .28, p < .001), and PRB scores were uniquely related to lifetime alcohol use only with transformed scores (see table; with untransformed scores, β = −.10, p = .182). Finally, the Step 1 regression addressing emotional abuse was significant in analyses with transformed variables (see table) but not in analyses with untransformed variables, R² = .01, F(2, 190) = 1.12, p = .329. ^bAnalyses of lifetime marijuana use yielded a significant effect of PRB only for transformed scores (see table; for untransformed scores, βs < |.04|, ps > .680).

p ≤ .05. **p < .01. ***p < .001.

In contrast to all the above, none of the regression models was significant for postdiction of criminal charges for violent or nonviolent offenses—either controlling for overall childhood maltreatment or controlling for emotional abuse (all R² values ≤ .01, all Fs < 2.20, ps > .139). Neither CTQ total scores nor CTQ emotional abuse scores were related to violent charges (βs < |.10|, ps > .280) or nonviolent charges (βs < |.13|, ps >.160), and there were similarly no significant effects for PRB scores (βs < .10, ps >.280).

The main effects of PRB for lifetime alcohol use were somewhat inconsistent across analyses with transformed versus untransformed scores, but the PRB × Overall maltreatment interaction was consistently reliable, R² = .02, F(1, 192) = 3.91, p = .049 (for transformed scores), reflecting a more positive relation between PRB and alcohol use at lower than at higher levels of maltreatment. Bootstrapping analyses using PROCESS (Hayes, 2012) demonstrated that, at low and average levels of overall maltreatment (but not at high levels of maltreatment), PRB scores were positively associated with self-reported alcohol use (b_low = .28, CI [0.11, 0.46], p = .002; b_average = 0.19, CIs [0.06, 0.31], p = .004; b_high = 0.09, CIs [−0.06, 0.23], p = .228). Modified CTQ emotional abuse scores were not related to alcohol use in any analyses (βs < .14, ps > .130), and there were no interactions between emotional abuse and PRB (βs < −.37, ps > .130). Otherwise, the specific pattern of findings was different for analyses with transformed scores versus for untransformed scores.³

There were no consistent unique effects of PRB in analyses for lifetime use of marijuana. None of the main effects for overall maltreatment or emotional abuse was significant (βs <|.12|, ps > .190). The effect of PRB scores was significant only in analyses using transformed scores.⁴

In contrast, PRB was uniquely related to lifetime hard drug use. As noted above, GLiMs were used to examine hard drug use. A negative binomial regression including PRB and overall maltreatment demonstrated that PRBs uniquely predicted hard drug use (IRR = 1.28, 95% CI [1.06, 1.54], p < .001), but overall maltreatment did not (IRR = 0.94, 95% CI [0.86, 1.05], p = .110). Similarly, there was a unique effect for PRB (IRR = 1.23, 95% CI [0.98, 1.56], p = .003) after controlling for emotional abuse, but the effect of emotional abuse was not significant (IRR = 0.97, 95% CI [0.71, 1.38], p = .871).

Discriminant Validity

There were no significant relations between PRB scores and demographic variables. A GLiM indicated that PRB scores were not related to participants’ ages. For age, the Poisson regression provided the best fit to the data, and no main effects or interactions approached significance (for all main effects, IRRs = 0.99-1.00, ps > .720, with 99% CIs ranging between 0.96 and 1.03; for interactions, IRRs = 1.00-1.01, ps > .340, 99% CIs between 0.99 and 1.04. Similarly, PRB scores were not related to participants’ estimated IQs, r(175) = .11, p = .166. A one-way analysis of variance was conducted to determine relations between PRB scores and participants’ ethnicities (after excluding biracial and multiracial participants), and results indicated that these variables were not significantly related, F (2, 178) = 1.67, p = .191.

Assessing Whether Some Correlations Between PRB and Other Indices Are Greater Than Others

Dependent Z tests revealed stronger relations between PRB and depression than between PRB and involvement in violent and nonviolent criminal activity, Zs = 3.07, 3.46, respectively, both ps = .001. Apart from these differences, correlations between depression and PRB were not consistently stronger than the correlations between PRB and indices of other forms of psychopathology examined, although some differences between correlations proved significant only for transformed or only for untransformed scores.⁵ Relations between PRB and anxiety were not stronger than relations with other forms of psychopathology examined at the alpha level of .01. The only other findings that emerged from Z tests were that the relation between PRB and modified CTQ Emotional Abuse subscale scores was stronger than the relation between PRB and physical neglect scores, Zs = 4.07, p < .001, and stronger than the relations between PRB and all CEQ scores, Zs > 4.10, ps < .001.

Discussion

Current analyses provide substantial evidence for the utility of the current PRB scale. Analyses demonstrated that adolescents’ scores on the measure of PRBs were reliable and valid as indicated by the pattern of relations with indices of child maltreatment, internalizing psychopathology, and externalizing psychopathology, as well as by evidence of discriminant validity. Moreover, a subset of these associations were reliable even after controlling for indices of overall abuse experiences or specific experiences of emotional abuse from the CTQ, and interactions between PRB and childhood maltreatment were observed in one case. Although there were few significant differences in the magnitude of the correlations with indices of psychopathology examined here, relations between PRB and depression appeared greater than some other relations examined. Each of these kinds of findings is addressed separately.

Concurrent Validity of PRB Scores

We first consider relations between PRB and indices of exposure to adverse environments. These analyses suggested somewhat more consistent relations between PRB and indices of childhood maltreatment than between PRB and community exposure to violence. Notably, although PRB scores were related to indices of all forms of child maltreatment assessed by the CTQ and CEQ total scores, they correlated with scores on only one of two subscales of exposure to community violence. This pattern of findings suggests that scores on the PRB scale do not reflect all forms of environmental risk equally but are associated especially with forms of maltreatment involving parents or other caregivers.

Convergent Validity of PRB Scores

In addition, although zero-order relations between PRB and psychopathology were relatively general, the unique relations were specific to depression, CD, and hard drug use. The zero-order correlations we observed are largely similar to those previously reported for other indices of parental rejection or hostility and internalizing and externalizing psychopathology (Buehler et al., 2006; Burge & Hammen, 1991; Conger et al., 1994; Ge et al., 1996; Marchand et al., 2002; O’Leary et al., 1999), including substance abuse (Barnow et al., 2002). Similarly, McKee et al. (2008) reported that measures of parental hostility were associated with internalizing symptoms in 13 of 20 studies and with externalizing symptoms in 19 of 21 studies. Few studies have, however, examined the unique impact of hostile parental behaviors and attitudes after controlling for other indices of maltreatment.

Unique Relations Between PRBs and Specific Forms of Psychopathology

The current study also provides evidence of direct unique relations between indices of PRB and indices of depression, conduct problems, and the use of hard drugs. Analyses indicated that adolescents’ reports of PRB were uniquely associated with self-reported depression and lifetime use of hard drugs and interviewer-rated CD symptoms after controlling for overall levels of self-reported child maltreatment or after controlling specifically for self-reported emotional abuse. Nevertheless, these unique relations stand in contrast to the lack of unique relations between PRB and anxiety scores and the lack of unique direct relations with other indices of lifetime substance use, suggesting that the zero-order correlations between PRB and these other indices of psychopathology largely reflect shared variance between PRB and other measures of childhood maltreatment.

The consistency and specificity of the relations with CD symptoms and hard drug use raises the possibility that parental rejection could be more deeply related to these adolescent behavior problems than to anxiety or most forms of substance use. To the extent that parental rejection places youth at increased risk for subsequent psychopathology, much of this risk may overlap with the impact of other aspects of parental antipathy or maltreatment. Rejection may, however, have implications for conduct problems and hard drug use that are not well captured by common self-report measures of maltreatment.

Similarly, the finding that a unique relation between PRB and depression was evident after controlling for emotional abuse and after controlling for overall maltreatment also suggests the possibility that parental rejection may be more closely related to depressive disorders than to some other forms of psychopathology. Of course, it remains an empirical question whether these relations will prove robust in independent samples.

We also observed an interaction between PRB and overall childhood maltreatment in the prediction of self-reported lifetime alcohol use. At low levels of self-reported childhood maltreatment, PRB was associated with higher levels of lifetime alcohol use, and the utility of PRB diminished as reported childhood maltreatment increased. This finding suggests the possibility that measures like the PRB scale may be useful in identifying subtle aspects of parental antipathy that might not impact reports of overt maltreatment as this construct is sampled on measures like the CTQ, but that may still place children at heightened risk for some negative outcomes. The lack of independent utility of PRB at high levels of maltreatment likely reflects that, at higher levels of maltreatment, measures like the CTQ adequately capture the variance shared with lifetime alcohol use. Moreover, the absence of effects of PRB on alcohol use in analyses that controlled for emotional abuse suggests that the PRB does not provide additional utility in assessing risk for subsequent alcohol use beyond that afforded by the CTQ measure of emotional abuse.

Taken together, the main effects and interactions have both pragmatic and theoretical implications. From a practical perspective, a measure addressing subjective estimates of the frequencies of specific kinds of events may have utility for identifying youth at heightened risk for some important negative outcomes. To the extent that this measure identifies youth characterized by experiences of parental hostility or rejection, it may help identify those for whom interventions may be warranted. In light of links between parental rejection and indices of some forms of personality disorder (Lengua, 2006; Rohner & Brothers, 1999), a measure of PRBs may also prove useful for clinicians working with those at heightened risk for personality pathology, including borderline personality disorder. At the same time, these findings raise theoretical questions about whether the PRB is effective primarily because it focuses respondents on recalling the frequency of events, which helps circumvent any resistance to reporting maltreatment, or whether its utility reflects the possibility that quantifying rejecting behaviors helps reveal hostile attitudes or a component of emotional abuse that more traditional measures of abuse and rejection do not fully capture. Only additional research can address this issue. From both perspectives, current findings suggest that research using the PRB (or similar measures) may contribute to an improved understanding of the nature of parental antipathy and maltreatment.

Are PRBs More Associated With Some Adverse Experiences or Forms of Psychopathology Than With Others?

The pattern of significant correlates appears consistent with the view that rejecting behaviors may be more closely related to emotional abuse than to some other forms of exposure to childhood adversity. Whereas most of the effect sizes for correlations between PRB scores and indices of child maltreatment were moderate, the effect size for the correlation between PRB and a modified index of emotional abuse was large. Moreover, the PRB-emotional abuse relation was stronger than the relation between PRB and physical neglect. In addition, the PRB correlation with the modified CTQ Emotional Abuse subscale score was stronger than the corresponding correlations between PRB and CEQ indices. PRB was not, however, more strongly associated with most other indices of maltreatment than with any other indices of exposure to maltreatment or violence. These findings provide some evidence for specificity in the relations between PRB and indices of exposure to adverse childhood experiences.

Some specificity in the pattern of associations was also evident in correlations between PRB scores and indices of psychopathology. As noted above, PRB scores correlated moderately with an index of depression but displayed only small correlations with most other indices of internalizing or externalizing psychopathology and were unrelated to indices of violent and nonviolent criminal activity. Although the correlation between PRB and depression was stronger than the correlations between PRB and criminal conduct and age, PRB was not more strongly linked to depression than to anxiety or conduct problems or substance use. In short, Z tests provide evidence for some specificity among the correlates of PRB scores but do not indicate that PRB is associated only with one form of psychopathology. Although partial correlations were not compared statistically, the pattern of partial correlations (see Table 3) suggests that, with the exception of trait anxiety, most of the relations between PRB scores and psychopathology do not reflect the shared variance between PRB and CTQ scores. More concretely, the correlation between PRB and anxiety scores drops to nonsignificance after controlling for indices of overall maltreatment and is near zero after controlling for CTQ emotional abuse. In contrast, correlations between PRB and indices of depression and conduct problems before 18 and hard drug use remain significant even after controlling for overall maltreatment scores and even after controlling for modified CTQ emotional abuse scores. The evidence of relations between PRB and lifetime alcohol use after controlling for scores on other indices of maltreatment in some analyses raises the possibility that there may also be something distinctive about the link between perceived rejection and alcohol use. Because the PRB correlation with alcohol use was significant only in analyses that corrected for skewness, however, no conclusion about this relation can be offered at this time.

Limitations

This study was characterized by several important limitations. Because all these measures were completed concurrently, it is also important to emphasize that this study does not provide evidence that PRB predicts the later development of depression or conduct problems or drug use. It is plausible that conduct problems or drug use may lead to conflictual interchanges with parents that in turn result in adolescents’ recalling negative interactions as more frequent. Only longitudinal designs can establish whether parents’ expressed hostility or rejection predicts the subsequent development of these outcomes. In addition, although we observed no evidence for unique direct relations with any other indices of psychopathology, there were several forms of childhood psychopathology not examined (e.g., eating disorders, attention deficit hyperactivity disorder, and childhood psychosis). It is possible that an examination of other forms of psychopathology would also yield unique associations with memories of rejecting parenting.

Some additional limitations of this study must be acknowledged. First, interview and self-report data are subject to social desirability biases that may have reduced participants’ willingness to indicate the occurrence of negative interactions with parents (e.g., Bowling, 2005). Although, as noted above, the use of a measure focused on memory for specific events may have reduced the need for participants to make inferences about parental traits or attitudes, this method may not protect against participants evaluating their memories and deciding not to report prior events accurately. In this context, it is noteworthy that the relations we have reported between rejecting behaviors by parents and indices of psychopathology appear similar to those reported using other measures of parental rejection (e.g., Campos et al., 2013; Quirk et al., 2014).

In addition, because we did not compare the PRB Scale with other measures of parental rejection, the present study does not demonstrate that the current measure or approach to assessing PRBs provides insights not obtainable through other measures. In particular, some apparent similarities between the PRB measure used here and the Parental Acceptance–Rejection scale (PARQ; Rohner et al., 2005; Rohner & Khaleque, 2005) raise the possibility that this measure may also provide information based on a child’s memories of specific kinds of parental behaviors and interactions likely to be indicative of rejecting parental attitudes. Given the development of four validated PARQ subscales to distinguish warmth/coldness from hostility/aggression, indifference/neglect, and undifferentiated rejection, it is plausible that multicomponent measures, such as the PARQ, may permit a more differentiated assessment of the consequences of parental rejection than the PRB. Even so, because several items on other measures (including on the PARQ) appear to require inferences by the child regarding attitudes of a parent (e.g., “My mother does not love me”) or inferences about his or her own feelings (e.g., “My mother makes me feel wanted and needed”), assessing youth with measures like the PRB scale may contribute to the assessment of parental rejection above and beyond the contributions of preexisting measures of parental rejection.

Even so, the current study appears to be the first both to report such relations using a subjective measure focused exclusively on the frequency of specific parental behaviors and to provide evidence of direct relations between frequency estimates and indices related to psychopathology even after controlling for scores on measures of emotional abuse or overall child maltreatment histories. As with all novel findings, assessing the replicability of these findings in an independent sample is critical to evaluating the importance of the current approach to assessing parental rejection. Moreover, because current participants were detainees, the current sample likely reflects higher levels of psychopathology than in many other adolescent samples. It cannot be assumed that these relations will prove reliable in clinical and community samples of adolescents. Studies with independent samples are needed to address the robustness of relations between subjective indices of PRBs and symptoms of specific forms of child psychopathology, as well as to assess the cognitive, affective, physiological, and behavioral mechanisms underlying these relations.

Finally, current findings occur in the context of strong evidence for the importance of genetic factors and increasing evidence for the importance of environmental factors for both internalizing and externalizing disorders (e.g., Kendler et al., 2011). Although our focus on rejecting behaviors by parental figures appears to suggest an adverse environmental impact on children, it is important to acknowledge that the current study was not designed to address whether relations between PRB and indices of psychopathology reflect genetic versus environmental factors. Consequently, as in any non-behavior-genetic study, it remains possible the apparent relations between adverse environmental factors and psychopathology observed here may reflect gene–environment correlations (Auty et al., 2015; Moffitt, 2005).

We have noted that the utility of adolescents’ memories of the frequency of specific interactions with parents do not depend on their memories being entirely accurate. Nevertheless, any assessment of adolescents’ retrospective recall may be compromised by a variety of factors: the difficulty of recalling events early in life, forgetting that occurs over time, and several distinct forms of interference, including subsequent events that distort earlier memories, the reconstructive nature of memory, and the possibility of memory impairment due to traumatic brain injury or consumption of alcohol and drugs. To the extent that the findings reported here prove robust, additional studies of adolescents’ memories of the frequencies of specific events may prove useful in both assessing and in understanding risk for subsequent psychopathology.

Footnotes

Acknowledgements

We are grateful to Dr. Susan Altfeld for suggesting the importance of examining parental rejection of children and to Dr. Maria T. Daversa for her work on an earlier study, which suggested the promise of studying PRBs. We thank Louise Loud, Leonard Young, Robert Cesar, Susan Korpai, Dr. Michael Fletcher, Dr. Holly Hinton, Rosemarie Gray, and the staff of Depke Juvenile Justice Complex in Vernon Hills, Illinois for their support of this research. We also thank Dr. Steven Miller for consultations regarding the estimation of GLiMs and Emily Graupman for help in converting IQ subtest scores to full scale IQ estimates.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research and preparation of this article were supported by a Pilot Grant from the School of Graduate and Postdoctoral Studies, Rosalind Franklin University of Medicine and Science to David Kosson and Cami McBride.

ORCID iD

David S. Kosson

Notes

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