Parenting styles and alcohol consumption among Brazilian adolescents

Abstract

Aim: This study evaluates the correlation between alcohol consumption in adolescence and parenting styles of socialization among Brazilian adolescents. The sample was composed of 273 adolescents, 58% whom were males. Instruments were: 1) Sociodemographic Questionnaire; 2) Demand and Responsiveness Scales; 3) Drug Use Screening Inventory (DUSI). Study analyses employed multiple correspondence analysis and logistic regression. Results: Maternal, but not paternal, authoritative and authoritarian parenting styles were directly related to adolescent alcohol intake. Conclusions: The style that mothers use to interact with their children may influence uptake of high-risk behaviors.

Keywords

adolescent alcohol parenting styles parental monitoring secondary prevention students

Introduction

Adolescence, one of the most important periods of human development, is characterized by rapid physical, psychological and social transformations. Adolescence is a period of personality consolidation, focusing on self-concept, self-esteem formation, and the ongoing development of cognition (Meteyer & Perry-Jenkins, 2009; Suchman, Pajulo, Decoste & Mayes, 2006). In adolescence individuals begin a journey of independence from their parents as they develop their own complex social networks. They adopt new and significant roles, choose a profession, form affective and sexual relationships, and initiate potentially risky behaviors such as alcohol use (Carretero & Léon, 2004; Kuntsche & Stewart, 2009; White & Halliwell, 2010).

Because they experience a period full of intense psychosocial transformations, adolescents are vulnerable to hazardous behaviors such as alcohol abuse, something that has been underscored by the latest Brazilian epidemiologic studies (Carlini, Galduróz, Noto & Nappo, 2005; Laranjeira, Pinsky, Zaleski, & Caetano, 2007; Guo, Hawkins, Hill & Abbott, 2001). These studies found adolescents had dependence rates of 7 percent, lifetime use rates of 54.3 percent, and weekly binge drinking rates of 13 percent of all adolescents (17% of boys). Besides, among the youth who consume alcohol in Brazil, 16 percent are binge drinkers, from these 21 percent are men and 12 percent are women (Schenker & Minayo, 2005; Simons-Morton, 2004).

In order to understand this behavior, several authors have pointed to the family as one of the main factors in this complex interplay, with an important role in the production of risk as well as protective factors (Cecconelo; Antoni; Koller, 2003; Newman et. al., 2008) This may be explained by the fact that many social behaviors, possibly including the use of psychoactive substances, are predominantly learned from interactions between youth and their primary socialization sources, which in the western world are mainly family, school and peers (Schenker and Minayo, 2005; Shope et al., 2001; Simons-Mortons, 2004).

The constant interaction between parents and child communicates a set of rules. Perceived difficulties in these social interactions can introduce serious risk factors for development (Costa, Teixeira and Gomes, 2000; Glasgow, Dronbush, Troyer, Steinberg and Ritter, 1997; Jackson C, Henriksen L, Dickinson D, 1999; Kuntsche and Stewart, 2009; Suchman, Pajulo, Decoste & Mayes, 2006; Shuckmith, Glendiming & Hendry, 1997; White & Halliwell 2010).

The landmark works by Baumrind (1966, 1971) and Maccoby and Martin (1983) described parenting styles of socialization and linked them with the use and abuse of psychoactive substances among adolescents. According to Maccoby and Martin (1983), parenting styles are defined as a function of two underlying dimensions: demandingness (control) and responsiveness (support/affect). According to this concept, a typology of four parenting styles may be recognized. Authoritative parents are characterized by being highly demanding and affectively involved with the children at the same time. Authoritarian parents may be understood as they demand a lot and offer little affect, that is, their demands are out of keeping with their acceptance of their children’s demands. The permissive-indulgent type demands little responsibility and maturity, allowing the children to monitor their own behavior. Finally, uninvolved parents are understood as having a permissive and indifferent behavior, with a low degree of control of and affect towards the children (Maccoby and Martin, 1983).

Compared to uninvolved, authoritarian, indulgent parents, numerous studies have found that authoritative, non-permissive parenting style is positively correlated with less use of alcohol and other drugs among adolescents (De Michelli and Formigoni, 2000; Maccoby and Martin, 1983). In addition, studies in Europe and the United States found that authoritarian educational approaches had an effect on reducing the odds for the substance use among Hispanics and Asians. These findings suggest that cultural differences may influence parenting styles, as well as the values about alcohol and other drugs use among young people. (Cohen & Rice, 1997; Radziszewska et. al., 1996).

The goal of the present study was to understand the relationship between alcohol use and parenting styles among adolescents in Brazil, in order to better understand cultural differences related to this behavior among brazilian adolescents.

Materials and methods

Participants

The study involved 273 adolescents, aged from 14 to 19 years, attending one of three State-run secondary schools in the municipalities of Juiz de Fora and Rio Pomba in the state of Minas Gerais, Brazil. The sample was constructed from a list with the names of all students enrolled in secondary education at each institution. EpiDat (3.1 version) was used to randomly select students to be invited to take part in the research. The sample was stratified according to gender and school year and strata sizes were constructured proportional to the entire population distribution.

Principals of the schools were informed about the aims of the study and authorized data collection. In order to be included in the study, each student: 1) provided oral informed consent; 2) was present in the classroom at the time of data collection; 3) completed 90 percent of study surveys. The project was submitted to and approved by the Ethics and Research Council of the Federal University of Juiz de Fora, Minas gerais, Brazil (document n° 0174.0.180.000-07).

Data collecting procedures

The questionnaires were administered in April 2008. Students were informed of study procedures, and asked for oral consent, in a private room. Instruments required 45 minutes to complete. After data collection, three individuals were excluded: two were over the study age limit (19 years old), and one did not fill in the instruments correctly. Twenty individuals were further excluded, once it was felt that the final sample should be composed of adolescents who reported they had knew both their father and mother. The final sample consisted of 250 subjects.

However, the number of responses used for analysis consisted of 186 and 200 cases for mothers and fathers, respectively. In 64 questionnaires about mothers and 50 about fathers, demandingness or responsiveness scores coincided with the median and were excluded from calculations (Newman et. al., 2008). Rationale provided under Instruments, below.

Instruments

Sociodemographic Questionnaire

This assessed the socioeconomic profile of the participants including gender, age range, schooling year, family income, housing, religion, and presence or absence of parents who are heavy drinkers.

Responsiveness and Demandingness Scales

This instrument was used to define the four parenting styles studied (authoritative, authoritarian, uninvolved and indulgent). This scale is composed of six questions on parental demandingness and ten questions on parental responsiveness, according to the theoretical model proposed by Maccoby and Martin (1983). All questions are assessed as a 3-point Likert scale. Demandingness and responsiveness scales were used by Lamborn, Mounts, Steinberg and Dornbusch (1991) in a study that investigated the relation between parenting styles and competence and adjustment patterns during adolescence. They were validated for the Portuguese/Brazilian context by Costa, Teixeira and Gomes (2000), who used the median value to discriminate between high and low values of the demandingness and responsiveness dimensions.

Drug Use Screening Inventory - (DUSI)

This screening instrument, adapted to and validated for Portuguese/Brazil by De Micheli and Formigoni (2000), was used to assess alcohol intake among the subjects. The inventory assesses the frequency of alcohol intake during the month preceding survey administration, through an item with the following possible answers: a) did not use; b) once or twice; c) 3 to 4 times; d) 5 to 9 times; e) 10 to 15 times; f) 16 to 20 times; g) more than 20 times. Binge drinking was assessed in a similar manner with the following responses: a) no dose; b) 1 to 2 doses; c) 3 to 4 doses; d) 5 to 9 doses; e) 10 to 15 doses; f) 16 to 20 doses; g) more than 20 doses.

Data analysis

The collected data were organized and entered in the SPSS statistics software (version 15.0). Descriptive analyses defined frequencies, percentages, means, medians, and standard deviations. Multiple correspondence analysis was used for exploratory analysis in order to identify association trends between the explanatory variables and the outcomes. Finally, we conducted logistic regression analyses between all covariates and the dichotomous outcomes: drank/did not drink and binge/no binge, in an attempt to rank the set of independent variables significantly associated (p < 0.05) with the dependent variables. Throughout the analysis process we sought the best explanatory model for the set of data found and assessed the degree of effect of the variables over the outcomes.

Results

Table 1, describes our sample. Most (58%) of the students were male. Approximately 62% were over 16 years of age, and 46% attended the first year of secondary school at the time of data collection. Most individuals lived with their parents (65.2%), 34.8% lived with other students or with relatives, and 7.6% reported that father and/or mother were heavy drinkers or addicted to alcohol.

Table 1.

Characterization of Dependent and Independent Variables

Variables	F	%
Gender
Male	146	58.4
Female	104	41.6
Age (years)
14 e 15	97	38.8
16	79	31.6
17 a 19	74	29.6
Schooling Year
1st	115	46.0
2nd	63	25.2
3^rd	72	28.8
Familiar Income (US$)
340 - 1020	72	28.8
1021 - 1700	90	36.0
1701 - 3400	58	23.2
> 3400	30	12.0
Father’s Education
Secondary	153	61.2
Undergraduate incomplete	27	10.8
Undergraduate complete	57	22.8
Not informed	13	5.2
Mother’s Education
Secondary	143	57.2
Undergraduate incomplete	21	8.4
Undergraduate complete	79	31.6
Not informed	07	2.8
Housing
Live with both parents	163	65.2
Do not live with both parents	87	34.8
Religion
Yes	203	81.2
Not	47	18.8
Father/mother heavy drinker
Yes	19	7.6
Not	231	92.4
Alcohol use (last month)
Yes	140	56.0
Not	110	44.0
Binge drinking
Yes	77	30.8
Not	173	60.2

After an exploratory analysis of all variables we undertook a dichotomous logistic regression analysis using multiple correspondence analysis in the exploratory step with the two study outcomes, drank and binge, as dependent categorical variables (supplementary points in CA). Explanatory variables that were not significantly correlated with outcomes (p < 0.05) were eliminated from further analyses. These included religion, father’s/mother’s schooling, family income, and father/mother who drank or were addicted to alcohol, once the correlation between them and the outcomes studied were not statistically significant.

After this step, another multiple correspondence analysis with the remaining variables was performed with maternal and paternal parenting styles separated. Dimension 1 in Figure 1 shows the separation between subjects with opposite alcohol intake behavior (drank/did not drink, binge/no binge). As found in other studies, a maternal authoritative style was correlated with the absence of alcohol intake by the adolescent. Alcohol abstinence was also associated with female gender, younger age (14 and 15 years), and parents in the household. Conversely, alcohol intake correlated with the other maternal parenting styles (uninvolved, indulgent and authoritarian), in addition to a number of other variables, including household without the parents, male gender, older age (17 to 19 years), and attendance to the third year of secondary school. Dimension 2, subjects with a higher family income and mothers with more schooling years were not linked to those with lower income and mothers with fewer years of formal education (see Figure 1).

Figure 1.

Multiple correspondence analysis of the set of variables concerning the maternal parenting style

Authoritative and indulgent styles remained associated with the abstinence and absence of binge drinking (Figure 2, Dimension 1). Female gender, younger age and parents in the household followed the same trend shown in Figure 1. Unexpectedly, uninvolved and authoritarian paternal parenting styles were closer to and directly correlated with alcohol use, as well as male gender, household without the parents and older age (see Figure 2).

Figure 2.

Multiple correspondence analysis of the set of variables concerning the paternal parenting style

We entered all significant variables into multiple logistic analyses conducted separately for the parenting styles of fathers and mothers (see Table 2). Paternal socialization style was not significantly related alcohol use or binge drinking. Maternal authoritative and authoritarian parenting styles were protective against adolescent alcohol intake. To illustrate: the 0.39 odds ratio (OR) for authoritative style signifies that an adolescent with an authortative mother has a 39% risk of alcohol intake, or 61% protection, compared to an adolescent with an uninvolved mother. In addition to parenting style, age is an important risk factor for alcohol intake. Compared to older respondents (17 to 19 years old) younger adolescents (14 to 15 years old) had 34% of the risk for consuming alcohol.

Table 2.

Binary Logistic Regression of alcohol intake

Variables Maternal Parenting Style	Odds Ratio	95% CI
Authoritative	0.39	0.19 – 0.83
Authoritarian	0.81	0.33 – 1.99
Uninvolved	1.00
14 and 15 years	0.34	0.15 – 0.75
17 to 19 years	1.00

Source: Author

Last, maternal parenting style, and respondent age, and having a two-parent household are all significantly related to binge drinking (Table 3).

Table 3.

Binary Logistic Regression of binge drinking

Variables Maternal Parenting Style	Odds Ratio	95% CI
Authoritative	0.47	0.20 – 1.09
Authoritarian	0.32	0.10 – 0.87
Uninvolved	1.00
14 and 15 years	0.22	0.05 – 0.95
17 to 19 years	1.00
Live with the parents	0.47	0.23 – 0.94
Not to live with the parents	1.00

Source: Author

Discussion

Alcohol consumption has been recognized as a serious public health problem in numerous countries. In agreement with previous reports (Newman, Harrison, Dashiff and Davies, 2008; Paiva and Ronzani, 2009), we found that the family plays an important role in adolescent alcohol use. Specifically, authoritative mothers reduce adolescent odds for alcohol use, as compared with non-authoritative mothers, which confirms research undertaken in other social and cultural contexts (Jackson, Henriksen and Dickinson, 1999). The authoritative parenting style is based on a balance between high parental demandingness and responsiveness towards the children, favoring the expression of parenting practices such as bidirectional communication, effective monitoring, support and involvement, all with the potential to significantly protect against adolescent alcohol use and abuse (Fletcher, Steinberg and Wheeler, 2004).

The maternal authoritarian style is also protective against binge drinking. This may be important, once such maternal stance may be understood as not so hazardous in the Brazilian culture, being even beneficial regarding lower alcohol intake and the avoidance of other health hazardous behaviors, a finding that points to important cultural differences permeating the relationship between parents and children (Broman, Reckase and Freedman-Doan, 2006). In the Latin culture, a control and authority-centered role model may still be positively accepted, something that is rejected in other cultures, such as those from the Anglo-Saxon countries (Cohen and Rice, 1997).

It is noteworthy that the set of socialization goals and practices discussed by Darling and Steinberg (1993) must be added to the analysis and observation of parenting styles. Socialization goals may contribute to the understanding of how different parenting styles yield similar results for different outcomes. Parents may have specific educational values and goals that they wish to nurture in their children (Bem and Wagner, 2006). Once the authoritarian and authoritative styles were found to be protective, one may assume that besides the role played by the parenting style these mothers have established a lower level of alcohol involvement as a socialization goal, with the understanding that this is one element in the list of values to be implemented. Such consideration may also help with the understanding that different parenting styles may be important protective factors. Therefore, the parenting styles of socialization in our sample (authoritative and authoritarian), must be positively understood, as they not only protect against alcohol use, but may also significantly contribute to lower exposure to the risks of alcohol consumption and/or delay adolescent alcohol exposure till an older age.

As for the maternal uninvolved and indulgent styles, our results are in agreement with those from other studies (Simons-Morton, 2004; Schuckmith, Glendiming and Hendry, 1997), which indicated a significant association between these styles and more unfavorable outcomes of adolescent alcohol consumption. Both styles are characterized by low control and permissiveness, which may relate to low or inadequate monitoring and supervision of the children’s activities. The consequent difficulty to know what the children do and with whom they relate, leads to a relationship where there is no dialogue or support, something that does not effectively help the adolescent’s psychosocial development (Fletcher, Steinberg and Wheeler, 2004).

Another important point of our study was the significant presence of the mothers in the complex process of adolescent alcohol intake behavior, contrasting with the lack of correlation with the presence of the fathers. The adolescents’ perception of the importance of the maternal parenting style may indicate a greater involvement of the maternal figure with the care of the youth and the protection against health hazardous behaviors, such as the use of pyschoactive drugs, risky sexual behavior and violence, among others. Concern about the children’s well-being, monitoring, supervision, involvement and emotional support may still be linked to the perceived maternal role within the household, thus explaining the significant presence of the mother as a protective factor against adolescent alcohol use we found.

According to some authors (Ariés, 2006; Arriagada, 2000; Biasoli-Alves, 2000; Machado, 2001; Scavione, 2001), delegating offspring care to mothers is a historical and social construct. This holds true for Brazil, where material provision and offspring protection has traditionally been assigned to the father. Although the last decades have certainly witnessed a series of transformations in these roles, the marriage contract has maintained a great degree of continuity (Biasoli-Alves, 2000) through which the woman is responsible for the traditional household chores (child and home care) and the man is the provider of material resources (Scavione, 2001).

Overall, adolescents rated fathers lower in terms of both demandingness and responsiveness, compared with mothers. Fathers may be less involved in monitoring, supervision and support, which are all considered protective against adolescent alcohol and drug use and abuse. However, because the paternal parenting styles did not explain the outcomes analyzed, it may be assumed that the father’s influence (as a risk or protective factor) on adolescent alcohol consumption behavior may not be related to such parenting socialization practices or attitudes. In fact, other factors not assessed in our study, such as paternal alcohol intake pattern, parents’ beliefs about and expectations towards alcohol consumption, and specific communication about alcohol use, may all be very important variables for the definition of adolescent alcohol use behavior (Bryant, McDermott, Zapata, Forthofer, Brown and Chewey, 2006).

Because men are still the largest alcohol consumers (Laranjeira, Pinsky, Zaleski & Caetano, 2007), such behavior may not be seen by the fathers as a problem, something that may be differently perceived by the mothers as clearly hazardous and directly related to the child’s body and mind care. It may also be supposed that because alcohol use is not seen by the fathers as a socialization goal value, they may become more worried about the children’s professional career and job market, leaving health care entirely to the mothers, or adopting irrelevant postures and strategies (Bem and Wagner, 2006; Darling and Steinberg, 1993).

It is noteworthy that different family arrangements have been constructed and solidified in the Brazilian social, economical and cultural environments. The presence of the rigid father-mother-child triad has been gradually reduced in such arrangements. Although the massive access of women to higher education and the job market has reshaped these household relations, and forced men to redefine their responsibilities within the family, women are still subject to double work shifts, something that may give rise to domestic conflict and unfavorable outcomes regarding the psychosocial development of children and adolescents. Grandparents, uncles and aunts who help with children’s care is a common finding, as is the existence of single-parent families, with a growing percentage of single women as the only ones responsible for socialization, education and care of the children, with a strong impact on the social policies and services, which must effectively understand and meet the real needs of the Brazilian families (Arriagada, 2000; Reis, 1994).

A single, exclusively individual, adolescent-targeted outlook is not enough to precisely understand adolescent alcohol consumption and other health hazardous behavior, in order to inform the implementation of more effective public policies. The different actors and institutions that make up the social and cultural fabric must be involved, so as to unveil the way a complex interplay of factors can shape the adoption of behaviors such as alcohol use and abuse (Traverso-Yépez and Pinheiro, 2002).

Our study has some limitations. Because it was a cross-sectional study, our findings are correlational. Future studies should explore these relationships to identify whether causal relationships exist between parenting style and adolescent drinking. Furthermore, because our study assessed only the adolescents’ perceptions of parenting styles, there was no comparison with the parenting styles as perceived by the parents themselves or by behavioral raters.

Final considerations

Our findings suggest that maternal parenting style may help explain risks for adolescent drinking in Brazil. Fathers’ style appeared unrelated.

The presence and importance of the mother in the interplay of factors affecting adolescent alcohol intake becomes relevant for the planning, implementation and assessment of promotive, preventive and treatment strategies aimed to reduce adolescent alcohol intake and risk exposure time. Mothers have been traditionally and systematically involved in health education initiatives developed by health services, with fathers playing a reduced or insignificant role. There are several reasons that can account for this, such as paternal negligence, mother’s traditional leadership role in child care, lack of interest and/or organizational capacity of the health services to guarantee and/or stimulate a more effective participation of fathers in child care, and the organization of work that frequently hampers an effective participation of fathers in child care. Although we did not identify links between paternal style and child drinking outcomes, other paternal influences on child academic, psychosocial and emotional have been reported (DiClemente et al.,2001; Guo, Hawkins, Hill & Abbott, 2001).

It may be fundamental to increase the maternal involvement in the processes of health and education, so as to promote the adoption of favorable behaviors and prevent the development of behaviors that jeopardize the integral development of adolescents. Through the improvement of their socialization practices and strategies, fathers should also be involved in these processes, in order to strengthen the protective force of the family institution against the use and abuse of psychoactive drugs. Actions that raise parents’ awareness of their important role in the psychosocial development of their children, and in the consolidation of favorable beliefs, values and attitudes, may be very effective. Specifically, adolescents who perceive they get more support, who feel understood by their families, and have parents who discipline in a respectful way that supports autonomous thinking, show lower rates of drug and alcohol use and abuse. It is thus important that family-targeted actions be understood and implemented through a cooperative outlook, not excluding certain actors and/or assigning specific tasks to each family member, once such rigid and immutable roles have been increasingly questioned. Providing dialogue, information exchange and knowledge for all the involved actors (father, mother, children and others) may positively impact the health promotion of the whole family group.

Intervention projects targeting these groups (adolescents, family) deserve permanent attention and interest, with participation and interaction of different knowledge fields, once interdisciplinary, intersectorial, integral work may shed light on the best line of action to be taken, contributing to the autonomy and empowerment of subjects and social groups. The responsibility for health hazardous behaviors must be shared among public professionals and managers, economists, social assistants, educators, cultural agents, judicial workers and health workers, who, along with adolescents, parents and all society are key to overcoming such a serious problem as the use, abuse and dependence of alcohol and other drugs. Neither is there a single agent responsible for the problem, nor are some specific actors to blame. On the contrary, responsibility sharing and joint construction of alternatives are believed to be the best way forward.

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