Qualities of adolescent mothers' parenting

JOURNAL

OF ADOLESCENT

HEALTH

1994;15:163-168

ORIGINAL ARTICLES

esc PATRICIA L. EAST, Ph.D., KAREN L. MATTHEWS, M.P.H., L.C.S.W., AND MARIANNE E. FELICE, M.D.

Purpose: This study examined the interrelations among adolescent mothers’ parenting attitudes, parenting confidence, and parenting stress and the potential differences in these dimensions by mothers’ age, race and parity, and age and sex of child. Methods: Subjects were 119 former adolescent mothers (M age = 20.2 years) from predominantly poor, minority backgrounds (50% Hispanic, 27% AfricanAmerican, 17% non-Hispanic white). All subjects completed questionnaires about their parenting qualities twice an average of 10 weeks apart. All children were at least one year of age @f age = 37.2 months; range 12-50 months). Results: Results indicated that for some mothers there exists a triple jeopardy of low parenting coniidence, high parenting stress, and inappropriate parenting values. Young maternal age at delivery and young maternal age at the time of this study were associated with low child acceptance. Non-Hispanic white mothers had signiGantly more favorable parenting values than did African-American and Hispanic mothers, and African-American mothers reported significantly greater caretakiig confidence than did Hispanic mothers. No parity or sex of child effects were found. ConcZusions: These results suggest the presence of meaningful patterns of convergence and within-group variation for the psychological qualities of adolescent mothers’ parenting.

From the University of California, San Diego. bra Diego, Califarnia ghEs,K.L.M.) and University of h,kyland, Baltimore, Mqyland

. . ..

Address reprint requests to Patricia East, University of Cclifbmia. San Diego Medical Center, Department of Pediatrics, Division of Adolescent Medicine, 200 West Arbor Driw, Mail Code 8449, San Diego, CA 92203-8449. Manuscript accepted ]uly 22,1993.

KEY woRD5:

Adolescent mothers Adolescent mothers’ parenting. Child acceptance Parenting attitudes Parenting confidence Parenting stress

Most research examining the parenting of adolescent mothers has (a) focused on adolescents’ b&havior in the context of mother-infant interaction, and (b) compared adolescent mothers to adult mothers (l5). Adolescent mothers, when compared to adult mothers, are reportedly less sensitive, less verbal, and less responsive to their infants’ interactional cues. (4-7). However, by exarnining only group differences between adolescent mothers and adult mothers, it is not possible to learn of the potential for variation within groups of adolescent mothers. Indeed, it is important to recognize that not all adolescent mothers are alike. Some teenagers adjust well to the stresses and responsibilities of parenting, while others lack the maturity or confidence to optimally nurture their children. Moreover, knowledge about differences among adolescent mothers would have important intervention implications. For example, mothers who have dramatic and intense fee! ings of inadequacy and failure in the parenting role are likely +o withdraw emotionally and physically from their &i&en (8-11). In contrast, parents wh,o perceive high stress associated with parenting are likely to have heightened anger toward the ch8*d and to use punitive child-control strategies (12-15). Obviously efforts at intervention would be tailored differently to these two types of mothers. Studies that examine only behaviors of adolescent mothers overlook the importance of some of the psychological components such as parenting at-

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FAST ET AL.

titudes, perceived parenting stress, and maternal self-esteem. These may significantly impact on the way adolescents carry out their parenting functions and the nature of their parent-child interactions (W-18). For example, mothers who have unfavorable parenting attitudes, such as a high perceivtid value of physical punishment and inappropriate child expectations, are prone to using harsh, rejecting discipline strategies (19). These strategies have been linked with child anger, noncompliance, low self-esteem, and social withdrawal (13,20,21). In this study, we sought to address the shortcomings of previous research by examining potential sources of within-group variation on the psychological qualities of adolescent mothers’ parenting. Specifically, we examined the interrelations among three parenting dimensions: parenting attitudes, parenting confidence, and parenting stress among adolescent and young adult mothers. Second, we examined whether such qualities of adolescent mothers’ parenting varied by mothers’ age, race and parity, and age and sex of child.

Methods Subjects Subjects were 119 adolescent and young adult mothers (M = 20.2 years; range = 17.1-22.6 years; M age at delivery = 17.2; age range at delivery = 14-18.9) who were part of The UCSD Teen OB Follow-Up Study. The UCSD Teen OB Follow-Up Study involved 125 adolescents who received 36 months of postpartum case management services and 99 adolescents who did not receive any formal postpartum services. As part of the program evaluation, all subjects participated in semiannual interviews for 42 months postpartum. The 119 subjects of this study were willing to complete three parenting questionnaires at the time of their regularly scheduled semiannual interview. The 119 subjects who chose to complete these questionnaires did not differ from the 105 subjects who chose not to complete them with regard to demographic characteristics such as mothers’ age, race, parity, or child’s age aorsex. Of the 119 subjects, 52 received postpartum case management and 67 did not. There were no differences between the case-managed group and the nonmanaged group on any of the parenting measures. Subjects were from poor, predominantly minority racial backgrounds (50% Hispanic, 27% African-American, 17% non-Hispanic white, and 6% Other) and most mothers were unmarried at the

JOURNAL OF ADOLESCENT HEALTH Vol. 15, No. 2

birth of their child (81%). At the birth of the target chi id, the majority of mothers (87%) were primiparous; 12% had one other living child and one mother had two living children. The mean age of the target children was 37.2 months (range = 12-50 months) and 50% were boys. One hundred-and-two mothers (86%) completed the parenting questionnaires a second time an average of 10.2 weeks after the first session. Measures Subjects’ parenting attitudes were assessed by the Adult-Adolescent Parenting Inventory (19), a 32-i&m questionnaire designed to assess the following four parenting attitudes and values: (a) developmental expectations of child, (b) empathy toward child’s needs, (c) value of physical punishment, and (d) parent-child role reversal. Using adolescent samples, internal reliabilities for the four subscales [as reported by Bavolek (22)] ranged from -70 to -82 and the overall test-retest reliability was .76. Response options ranged from 1 (strongly agree) to 4 (strongly disagree) with high scones reflecting appropriate developmental expectations of child, high empathy towards child’s needs, high value of physical punishment, and high expectations of the child taking a parenting role. The first two scores reflect favorable parentig attitudes and the latter two scores reflect unfavorable parenting attitudes (i.e., those found to be correlated with child abuse and neglect) (19,22). The Maternal Self-Report Inventory (MSRZ) (11) was used to assess the following four dimensions of maternal self-esteem, or a mother’s feelings of confidence in the mothering role: (a) confidence in caretaking ability (to soothe and calm child), (b) confidence in mothering role (“I think that I am a good mother”), (c) acceptance of child (assessed by a mother’s !ove for her child, whether or not she was disappointed with the sex of her child, and whether or not she believed that her child would develop normally), and (d) expected relationship with child (“I am confident that I will have a close and warm relationship with my child”). For purposes of this study, the 26-item short form was used and the word “baby” was changed to “child.” In addition to having good face validity, the MSRZ has good concurrent validity (as compared with clinical ratings of the mother and general self-esteem scores of the mother), and good construct validity (11). All Cronbath alphas of the short form exceeded 81 except for expected relationship with child which had an

March1994

alpha of .66. Response options ranged from 1 (really false) to 4 (really true) with high scores indicating high confidence in one’s caretaking ability, high confidence in oneself in the mothering role, high acceptance of child, and positive expectations of the mother-child relationship. To assess the stress experienced with parenting, the Parenting Daily Hassles scale (PDH) (23) was used. The PDH lists 15 typical, yet stressful, everyday events in parenting and parent-child interactions (e.g., “I was nagged, whined at, or complained to by my kids”). In response to each item,. using a 4-point scale, mothers were instructed to rate the frequency of occurrence of the event (not at all, sometimes, a lot, constantly) and the intensity of how hassled they felt by the event (no hassle, a little hassle, kind of a big hassle, a big hassle). The internal reliabilities (Cronbach alpha) were .81 for the frequency scale and .90 for the intensity scale. Procedure The questionnaires were administered to all subjects at their convenience in their place of residence by a trained female research assistant. The assistant described the instructions for completing the questionnaires and was available to answer any questions regarding word definitions and to look after the mothers’ children. All subjects were assured of the confidentiality of their responses. The methods and procedures of this study were approved by the Internal Review Board for Human Subject Participation of the University of California, San Diego.

Results me Time 1 means of the four parenting attitude scales averaged 2.79, the four parenting confidence scales averaged 3.44, and the two parenting hassles scalmc aver-*-d A_”Y “5’ 1.85. Thus, the mothers in this study had moderately favorable parenting attitudes, high confidence in their parenting, and relatively low stress associated with their daily experiences of parenting. All of the parenting scales had high test-retest reliability (average r = .58), indicating that all aspects of parenting examined in this study were highly stable over the period studied. The intercorrelations among all of the (Time 1) parenting scores are shown in Tqble 1. Bonferonniadjusted probability values were used to gauge statistical significance in efforts to protect against obtaining significant probability values by chance. As shown in this table, the subscales of parenting atti-

ADOLESCENT MOTHERS’ PARENTING 165

tudes, parenting confidence, and parenting stress were all highly intercorrelated. (Results using The 2 parenting scores were comparable to those shown in Table 1.) Regarding the correlations between parenting attitudes and parenting confidence, au aspects of parenting confidence were significantly related to parenting attitudes except for acceptance of child. The frequency of parenting hassles did not correlate significantly with any of the parenting confidence or parenting attitude scales, yet the intensity of parenting hassles correlated negatively with empathy of child’s needs, confidence in caretaking ability, confidence in the mothering role, and acceptance of child. Thus, mothers who reported feeling high parenting stress had low confidence in themselves as mothers, low empathy to their children’s needs, and low acceptance of their children. Table 2 presents the correlations between the parenting scores and mothers’ age at delivery, mothers’ age at the time of the study, and age of the child. As in Table 1, Bonferonni-adjusted probability values were used to gauge statistical significance. Mothers’ age at delivery was significantly related only to acceptance of child, with younger mothers rep0rting low acceptance of their children. Acceptance of child also significantly correlated with mothers’ current age. In addition, mothers who were older at the time of the study placed greater value on physical punishment and had less confidence in their caretaking abilities. Only one of the 10 parenting scores correlated Ggtificantly with child’s age. Mothers who had older children placed greater value on physical punishment (r = .25, p < .Ol). Because mothers’ current age was correlated with child’s age, we computed partial correlations between all parenting scores and mothers’ current age while controlling for the age of the child. None of the 10 partial correlations was statrstically significant (all rs < .14; not shown in Table 2), except for the partial correlation between mothers’ cur:ent age and acceptance of child, which was .25 @ < .Ol). Thus, younger mothers were likely to have low acceptance of their children independent of the effects of the child’s age. Because mothers’ current age did not correlate significantly with punishment value or caretaking confidence while controlling for the effects of child’s age, it can be assumed that age of child inflated the original correlations between mothers’ current age and the value of physical pmishment (r = -25) and caretaking confidence (r = -20). There were no significant parity or sex of child effects for any of the parenting scores at either time of assessment.

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EAST ET AL.

‘Fable 1. Intercorrelations Among (Time 1) Parenting Scores

(2)

(3)

(4)

.64*** -

-.56***

_ .a***

- .59*** -

- .69*** .51*** -

(1) Parenting attitudes 1. Child expectations 2. Empathy to child’s needs 3. Punishment value 4. Role reversal Parenting confidence 5. Confidence in caretaking 6. Confidence in role 7. Acceptance of child 8. Relationship with child Parenting stress 9. Hassle frequency 10. Hassle intensity

-

.36*** .34*** -_x*** -.32*‘* -

.2a+ .37+** - .39+** - .29** .52*** -

.17 .15 -.13 -.03 .39*** .37*** -

.27*

-.Ol

-.05

.32*** -.36*** -.32”

-.09 .15 .03

-.21’ .16 -.I1

-.16 -.20 -.16 -.03

-.26* -.36*‘* - .23+ -.OY

,48’=+ .51+** .32*** -

-

.76**” -

Note. Bonferroni-adjusted probability valves were used to gauge statistical significance in efforts to protect against obtaining significant probability values by chance. *p < .05. *p < .Ol. ***$I< .OOl.

Age of child

confidence but were not found for either of the parenting hassle subscales. As shown in Table 3, non-Hispanic white mothers had significantly more favorable parenting values (i.e., greater empathy to child’s needs, lower expectations regarding the child’s nurturing role, more appropriate expectations of child, and less value of physical punishment) than did African-American or Hispanic mothers. In addition, African-American mothers reported significantly greater confidence in their caretaking abilities than did Hispanic mothers. Thus, Hispanic mothers appear not to have the benefit of appropriate parenting values, as compared to white mothers, nor parenting confidence, as compared to African-American mothers.

-.06 -.03

Discussion

whether adolescent Finally, to investigate mothers’ parenting values, parenting confidence, and parenting stress varied by race of mother, we conducted multiple analysis of variance using mothers’ race (Hispanic, African-American, or nonHispanic white) as the independent variable and the 10 parenting scores at both times of assessment as the dependent variables. Racial differences were evident in aspects of parenting values and parenting

Table 2. Correlations Among (Time 1) Parenting Scores and Mothers’ Age and Age of Child

Parenting attitudes 1. Expectations of child 2. Empathy to child’s needs 3. Value of physical punishment 4. Parent-child role reversal Parenting confidence 5. Confidence in caretaking ability 6. Confidence in mothering role 7. Acceptance of child 8. Expected relationship with child

Parentingstress

9. Parenting hassle frequency 10. Parenting hassle intensity

Mothers’ age at delivery

Mothers’ current age

.06 .04

.02 .02

.I1

.25*’ .12

.04

-.ll -03 .25** -.03 .14 .03

.25** .16

-.20’

-.18

-.06 .22*

-.15 .03

-.12

-.16

.12 .03

.02 .Ol

Note. Bonferroni-adjusted probability values were used to gauge statistical significance in efforts to protect against obtaining significant probabilky values by chance. *p < .05. **p c: .Ol.

The psychological qualities of adolescent and young adult mothers’ parenting examined in this study showed meaningful patterns of convergence and within-group variation. Specifically, mothers who had low confidence about themselves as mothers and low confidence about the future relationships with their children had unfavorable parenting attitudes such as high value of physical punishment, high expectations regarding their children’s nurturing role, and low empathy for their children’s needs. Similarly, mothers who reported high stress associated with parenting had low confidence in the mothering role, low acceptance of their children, and low empathy for their children’s needs. Because of these interrelations, it is likely that there exists a subset of mothers for whom there is a triple jeop-

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ADOLESCENT MOTHERS PARENTING

167

Table 3. Means Scoresand F Values Associated with Adolescents’ Parenting Scores by Mothers’ Race Hispanic

African-American

white

Time 1 scores Empathy to child‘s needs Parent-child role reversal

(N = 59) 2.79” 2.32“

(N = 32) 2.75b 2.22b

(N = 20) 3.15”b 1.99”b

F (df = 2,108) 5.74+* 4.82”

Time 2 scores Expectations of child Empathy to child’s needs Value of physical punishment Parent-chiId roie reversal Confidence in caretaking

(N = 46) 2.96” 2.84” 2.29” 2.17’ 3.04’

(N = 22) 2.89b 2.89b 2.286 2.21b 3.56’

(N = 14) 3.3W 3.36*,b 1.99-b 174”b 3135

F (df = 2,79) 6.31’* 7.65**’ 3.03* 5.61** 5.53**

Nofe: Means with the same letter suDerscriut in the same row are significantiy different from each other. “Hispanic/White contrast. A A bAfrican-American/White contrast. CHispanic/African-American contrast. *p c *05. **p < .Ol. **+p < .OOl.

ardy of low parenting confidence, high parenting stress, and inappropriate parenting values. Based on previous research, this subgroup is at high risk for neglectful, punitive, and rejecting parenting (816,19). More information is needed about the outcomes associated with these parenting attitudes and beliefs. Regarding the within-group variation of adolescent mothers’ parenting, mothers who were younger at delivery and younger at the time of this study had low acceptance of their children. Recall that this finding held up independent of the effects of child’s age. Several researchers have cautioned that the association between young maternal age and poor parenting is confounded by younger mothers more likely to be from lower socioeconomic families (1,~7). This was not the case with the current sample. Younger mothers were not of lower socioeconomic status, as indexed by subjects’ mothers’ highest level of education (maternal age at birth correlated with subjects’ mothers’ highest level of education .ll). Moreover, socioeconomic status was unlikely to confound these findings because all subjects were from low income backgrounds. Thus, within this sample of former adolescent mothers, the variability associated with maternal age appears to have clinical significance vis-a-vis child acceptance, independent of its relation to mothers’ socioeconomic status. This finding is important because it may reflect the inability of the very young mother to realistically adjust her expectations and fantasies of the baby she “wished for” to the baby she actually “gets.” The fact that younger mothers had low child acceptance when their children were as old as three years indicates that this is not a short-lived

phenomenon. Perhaps very young pregnant adolescents would benefit from prenatal and long-term postpartum counseling in order to help them develop more realistic expectations of their children and the relationships with their children. Results also indicated that mothers of older children were likely to advocate physical punishment as a means of discipline. These results suggest that, as their children reach toddlerhood and are striving for physical and emotional autonomy, adolescent and young adult mothers were enforcing physical punishment as a control strategy. Programs for young parents of toddlers that endeavor to increase parents’ capabilities of setting limits and enforcing rules within a nurturant, warm and understanding environment may be especially warranted (22). In addition, programs that foster social support have been shown to be especially promising for adolescent mothers who have harsh and punitive discipline styles (i3,15,24). The parenting measures used in this study were also sensitive to cultural/racial differences among mothers. While African-American and Hispanic mothers shared similar parenting attitudes, white mothers held quite different parenting values. Moreover, African-American mothers felt more confident about their caretaking abilities than did Hispanic mothers. Certainly efforts to intervene with young mothers and their children should appreciate these cultural variations in parenting. However, it should be noted that the subsample of white mothers in this study was particularly small, which may have precluded detection of significant differences across racial groups. Despite the relatively small subgroup sample sizes, however, differences

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EAST ET AL.

nonetheless emerged among mothers of different racial baclcgrounds. Another limitation of this study that may limit the generalizability of its findings was the self-selection among study participants. Women who completed the three parenting questionnaires, in addition to their regularly scheduled interview, may have differed from nonparticipants on characteristics related to quality of parenting. In addition, it would have been advantageous to learn of the relations between mothers’ parenting qualities and their personal psychological characteristics such as their psychosocial maturity and feelings of general selfworth. If significant associations could be noted, these characteristics could be assessed in the early postpartum period and used as a screening tool to identify those who might benefit most from parenting enhancement programs.

10.

11.

12.

13.

Thisresearch was supported by U.S. Public Health Service Grant APH-000~50 from the Office of Adolescent Pregnancy Programs of which Drs. Felice and East were Co-Principal Investigators. While preparing this article, Dr. East was supported by Grant R29-HD29472 from the National Institute of Child Health and Human Development and Dr. Felice was supported by Grant MCJ980 from the Maternal and Child Health Bureau. This study was also facilitated by Grant MOlRR00827 of the National Center for Research Resources, National Institutes of Health to the UCSD Medical Center’s General Clinical Research Center. The authors are grateful to the following individuals for their time and effort in data collection and data management: Beth Baker, Grace Barca, Donna Charielle, Carol Anne Drastal, Katy Engelhom, and Paul Shragg. We also appreciate the gracious cooperation of the young women who participated in this study.

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15.

16.

17.

18.

References 1. Conger RD, M&r@ JA, Yang RK, et al. Mother’s age as a pre&ctor of observid- matemil behavior in three mdependent samples of families. J Marr Fam 1984;46:411-24. Levine L, Garcia-Co11CT, Oh W. Determinants of mother-infant interaction in adolescent mothers. Pediatrics 1985;75:239. McAnamey ER, Lawrence RA, Ricciuti HN, et al. Interactions of adolescent mothers and their l-year-old children. Pediatrics 1986;7&58.!+9. Roosa MW, Fitzgerald HE, Carlson NA. A comparison of :eenage and older mothers: A systems analysis. J Marr Fam 1982;44:367-77. Teberg AJ, Howell W, Wingert WA. Attachment interaction behavior between young teenage mothers and their infants. J Adolesc Health Care 1983;4:61-6.

19. 20. 21.

22. 23. 24.

Panzarine S. Teen mothering: Behaviors and interventions. J Adolesc Health Care 1988;9:443-8. Elster AB, McAnamey ER, Lamb ME. Parental behavior of adolescent mothers. Pediatrics 1983;71:494-503. Colletta ND. At risk for depression: A study of young mothers. J Genet Psycho1 1983;142:301-10. Frommer E, O’Shea G. Antenatal identification of women liable to have problems in managing their infants. Br J Psychiat 1973;123:149-56. Main M, Goldwyn R. Predicting rejection of her infant from mother’s representation of her own experience: Implications for the abused-abusing intergenerational cycle. Monographs of Child Abuse and Neglect: The International J 1984;8:20317. Shea E, Tronick EZ. The Maternal Self-Report Inventory. in Fitzgerald H, Lester BM, Yogman MW, eds. Theory and Research in Behavioral Pediatrics. New York: Plenum Press, 1988; 101-139. Crnic KA, Greenberg MT, Slough NM. Early stress and social support influences on mothers’ and high risk infants’ functioning in late infancy. Inf Ment Health J 1986;7:19-33. Crockenberg S. Predictors and correlates of anger toward and punitive control of toddlers by adolescent mothers. Child Dev 1987;5&964-75. Mash EJ, Johnston C. Parental perceptions of child behavior problems, parenting self-esteem, and mothers’ reported stress in younger and older hyperactive and normal children. J Consult clin Psycho1 1983;51:86-99. Weintraub M, Wolf B. Effects of stress and social supports on mother-child interactions in single- and two-parent families. Child Dev 1983;54:1297-1341. Hamburg BA. Subsets of adolescent mothers: Developmental, biomedical, and psychosocial issues. In Lancaster JB, Hamburg BA, eds. Schooi-Age Pregnancy and Parenthood: Biosocial Dimensions. New York: De Gruyter, 1986; 115-145. Ketterlinus RD, Lamb ME, Nitz K. Developmental and ecological sources of stress among adolescent parents. Fam Relations 1991;40:43541. Osofsky JJ, Osofsky JD. Adolescents as mothers. Am J Orthopsychiat 1970;40:825. Fox RA, Baisch MJ, Goldberg BD et al. Parenting attitudes of pregnant adolescents. Psycho1 Rep 1987;61:4036. Crockenberg S. Toddlers’ reaction to maternal anger. MerrillPalmer Quart 1985;31:361-3. Rohner D. They Love Me, They Love Me Not: A Worldwide Study of the Effects of Parental Acceptance and Rejection. New Haven, CT, Yale University Press, 1975. Bavolek SJ. Adult-Adolescent Parenting Inventory. Eau Claire, WI, Family Development Assoc Press, 1984. Cmic KA, Greenberg MT. Minor parenting stresses with young children. Child Dev 1990;61:1628-37. GarciaCoB CT, Hoffman J, Oh W. The social ecology of early parenting of Caucasian adolescent mothers. Child Dev 1987;58:955-63.