Limitations

Despite good quality scores, limitations of studies require consideration.

1.5.2.1. Overview of methodological limitations.

As discussed, all studies are limited by relatively small samples, dichotomous classification of anxious and non-anxious parents and gender bias. Findings may be confounded by other parental and environmental factors which could affect both parental anxiety and parenting, such as inter-parental conflict (Rapee, 2001) or personality factors. Unremitting anxiety may be associated with personality disorder (Massion, Dyck, Shea, Phillips, Warshaw & Keller, 2002) and parents with personality disorders show non-optimal parenting behaviours when controlling for anxiety and depression (Johnson, Cohen, Kasen, Ehrensaft & Crawford, 2006). Studies did not assess personality disorder, thus potentially the presence of

personality disorder in addition to anxiety may have contributed to parenting behaviour in studies reporting significant findings. Furthermore, child factors such as birth order or temperament may influence parenting behaviour. Generalisability of studies may be reduced due to child age or anxiety disorder status. Studies

45 frequently sampled a large age range of children, which may miss potentially significant differences in parenting behaviours at specific developmental stages.

As stated, limitations arise from observing short interactional tasks, usually in non- home environments and from using varying construct definitions, incorporating numerous parenting behaviours rated using different coding schemes. Subtle differences evident between anxious and non-anxious parents (e.g. where differences approached significance) may impact children. Based on theoretical notions of parenting (1.2.2.), studies regard parenting behaviours as positive or negative, yet this is likely to be context-dependent – for example, in dangerous situations, controlling behaviour may be positive (Dibartolo & Helt, 2007).

Rating frequencies of behaviour does not consider that certain behaviours may have greater consequences for child outcomes and/or behaviours considered detrimental may be outweighed by other positive behaviours. For example, compared to English mothers, Italian mothers tend to display more over-controlling behaviours, but also display more warmth, which appears to counteract potential negative impacts on children. Levels of maternal warmth in Italian mothers moderated relationships between maternal intrusiveness and overprotectiveness and child anxiety (Raudino et al., 2013). Although this finding may reflect cultural

differences, in both parental behaviour and researcher’s interpretation of specific behaviours, it also suggests that the relationship between parental anxiety and behaviour is more complex than can be captured in frequency ratings.

46 Raudino et al.’s (2013) findings demonstrate that parenting behaviour may vary across ethnic or societal cultures. Findings in this review were based on samples of predominantly Caucasian, or African American (Ginsburg et al., 2004), participants and may not generalise to other ethnicities. Parenting styles adaptive in some cultures may be associated with negative child outcomes in others (Bornstein, 2012). Children may be affected by deviations from cultural norms of parenting behaviour – for example experiencing highly controlling parenting in comparison to peers may have a greater impact on children than experiencing highly controlling parenting which is commonplace in the child’s culture.

Key design limitations include the dominance of cross-sectional designs, which do not allow for assessment of changes in parenting over time or account for the potential dynamic nature of parenting. Also, the lack of including comparison groups meeting criteria for an alternative psychiatric condition means that significant findings could be due to mental health difficulties in general.

Children’s perceptions of parenting, rather than observable behaviours, may be more meaningful when considering how parenting affects children (Rohner, 2004). Rohner et al. (2005) suggest that undifferentiated rejection, an individual’s belief that their parents do not care, despite no clear behavioural indicators of this, is a significant aspect of the warmth dimension. Such rejection is overlooked in observational research.

47 1.5.2.2. Theoretical limitations.

Theoretically relevant parenting dimensions are poorly defined (Masia & Morris, 1998) and classifying parental behaviour is problematic. Clarification of parenting constructs is necessary, particularly developing clear, non-interrelated definitions for warmth and control (Dibartolo & Helt, 2007), which are of theoretical

importance. However, whether these dimensions are independent is contentious. Constructs such as overprotectiveness combine elements of both warmth and control (Thomasgard & Metz, 1993). Moreover, Rubin, Cheah and Fox (2001) suggest behaviour at the extreme end of warmth may be associated with control. It is likely that selecting appropriate behaviours for assessing these constructs is affected by cultural, temporal and group-specific factors, as behaviours may have different meanings for different groups.

Given some of the methodological limitations considered above, the research in this area is limited by the focus on quantitative studies. Parenting constructs are

evidently difficult to measure reliably; rating frequency of parental behaviours does not adequately capture dyadic processes and requires researchers to make

assumptions about how behaviours are perceived or experienced; problems are associated with dichotomous assessment of anxiety disorder. These limitations demonstrate the difficulty of measuring anxiety and behaviour, which presents a fundamental difficulty for the reductive theoretical stance of quantitative research. Furthermore, this stance assumes an objective ‘truth’ exists regarding parental behaviour. However, what an observer considers a behavioural manifestation of a

48 parenting construct such as warmth may not be considered as such by either/both dyad member(s). Factors such as personality, perception and interactional

experiences outside the observed interaction are all likely to contribute to how parents and children experience their interactions, and consequently, the impact these interactions have.