Cited by 353Family and Disability Support ResearchChild and Adolescent Psychosocial and Emotional DevelopmentPsychosocial Factors Impacting Youth

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Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: The mediational role of behavioral autonomy

Holmbeck, Grayson N., Johnson, Sharon Z., Wills, Karen E., McKernon, Wendy, Rose, Brigid, Erklin, Shannon, Kemper, Therese·2002·Journal of Consulting and Clinical Psychology

DOI 10.1037/0022-006x.70.1.96

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Abstract

The purpose of this study was to tes a mediational model of associations between parental overprotectiveness (OP), behavioral autonomy. and psychosocial adjustment in 68 families with 8- and 9-year-old preadolescents with spipa bifida and a demographically matched sample of 68 families with able-bodied children. Measures included questionnaire and observational assessments of parental OP; parent and child reports of behavioral autonomy; and parent, child, and teacher reports of preadolescent adjustment. On the basis of both questionnaire and observational measures of OP, mothers and fathers of children with spina bifida were significantly more overprotective than their counterparts in the able-bodied sample, although this group difference was partially mediated by children's cognitive ability. Across samples, mothers were more likely to be overprotective than fathers. Both questionnaire and observational measures of parental OP were associated with lower levels of preadolescent decision-making autonomy as well as with parents being less willing to grant autonomy to their offspring in the future. For the questionnaire measure of OP, and only for the spina bifida sample. the mediational model was supported such that parental OP was associated with less behavioral autonomy, which was, in turn, associated with more externalizing problems. Findings are discussed in relation to the literature on parenting, autonomy development, and pediatric psychology.

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“…from a longitudinal study that focused on family relationships and psychological adjustment in families of children with SB and a comparison sample of families of typically developing children (for a more detailed review of participant selection and methods, see Holmbeck et al., 1997, 2002, 2003).”
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“Importantly, these parental characteristics are predictive of children’s emotional, behavioral, and social adjustment [10, 11].”
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“High parental control may then be considered as protective and involved parenting [4,14].”
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Self-citation
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“…of barriers to success, such as reduced cognitive, physical and/or social skills (e.g. Friedman et al., 2009), parental overprotection (e.g. Holmbeck et al., 2002), social stigmatisation by peers (e.g. Masnari et al., 2012) and/or social anxiety (e.g. Noll, Bukowski, Davies, Koontz, &…”
Background
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“Though this has not been examined in the literature for individuals with SCD, this would be consistent with research indicating that individuals with a chronic illness that begins in childhood are at risk for being overprotected by caregivers (Holmbeck et al., 2002; Power et al., 2003).”
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“Although parental intrusiveness and overprotection in the management of SB may be adaptive early on when the medical care needs exceed the developing child’s capabilities (Holmbeck et al., 2002), our finding is consistent with previous messages to encourage independence early on (Betz, 2004; Loomis, Javornisky, Monaha…”
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“For example, Holmbeck et al. (2002) found that the parents of preadolescents with spina bifida tended to be more overprotective than the parents of their peers, which was correlated with negative outcomes in the youth, such as diminished autonomy in making decisions.”
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“…challenges for a parent in his or her ability to modify parental control and to provide age-appropriate levels of behavioral and emotional autonomy (Holmbeck et al., 2002; Holmbeck, Shapera et al., 2002), it is expected that children with SB would benefit from the same adjustments in parenting…”
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Background
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Background
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Background
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“Overprotection as well can have detrimental psychosocial effects on children [22–25].”
Background
Is Mindful Parenting a Mechanism that Links Parents’ and Children’s Tendency to Experience Negative Affect to Overprotective and Supportive Behaviors?
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BackgroundInfluential
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Self-citation
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Self-citation
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BackgroundMethodInfluential
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BackgroundMethod
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Background
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Background
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“…developmental and psychological issues (e.g., external locus of control, low self-efficacy, anxiety disorders, depression) (Herz & Gullone, 1999; Holmbeck et al., 2002; Lynch, Hurford, & Cole, 2002; McLeod et al., 2007a, 2007b; Scott & Mallinckrodt, 2005; Spokas & Heimberg, 2009; Ungar, 2009).”
Background
Clinical Team Perspectives on the Psychosocial Aspects of Transition to Adult Care for Patients With Childhood‐Onset Systemic Lupus Erythematosus
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“when compared to parents of children without a chronic condition (15,16).”
Background
An Examination of the Factor Structure of Parenting Capacity Measures in Chronic Illness Populations
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“The extant literature indicates that the predictive value of the PPS in relation to child adjustment outcomes in these populations is mixed, with illness-specific variables potentially playing a role in the utility of the PPS (Colletti et al., 2008; Holmbeck et al., 2002).”
BackgroundInfluential
Neuropathic Dysfunction of the Lower Urinary Tract
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Self-citation
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“…likely the result of a combination of psychological, social and biological factors including shared underlying pathology, increased uncertainty, peer relations, changes in parenting style and the side‐effects of medication (Holmbeck et al., 2002; Miller et al., 2008; Sandstrom & Schanberg, 2004).”
Background
Parents’ Storm and Stress Beliefs about Adolescence: Relations with Parental Overprotection and Parental Burnout
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“Parental overprotection refers to parents’ provision of protection that is excessive, considering the child’s developmental level (Holmbeck et al., 2002; Thomasgard et al., 1995; for a review about the concept of parental overprotection, see Venard, et al., 2021).”
Background
Observed Macro- and Micro-Level Parenting Behaviors During Preadolescent Family Interactions as Predictors of Adjustment in Emerging Adults With and Without Spina Bifida
Murray, C. B., Amaro, C. M., Devine, K. A., Psihogios, A. M., Murphy, L. K., & Holmbeck, G. N. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu030 · Cited by 18
Self-citation
Individual and family predictors of psychological control in parents raising children with type 1 diabetes.
Jubber, A. P., Roper, S. O., Yorgason, J. B., Poulsen, F. O., & Mandleco, B. L. (2013) · Families Systems & Health · doi:10.1037/a0032498 · Cited by 24
Game for health: How eHealth approaches might address the psychological needs of children and young people with long‐term physical conditions
Thabrew, H., Stasiak, K., Garcia‐Hoyos, V., & Merry, S. (2016) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.13271 · Cited by 18
Parenting of Adolescent Single Children: A Mixed-methods Study
Khadaroo, A., & MacCallum, F. (2021) · Journal of Family Issues · doi:10.1177/0192513x21993180 · Cited by 21
“For example, overprotective parenting was much more prominent amongst mothers than fathers and, freedom of choice was granted by mothers more than fathers; as also found by Holmbeck et al. (2002) and Saldinger et al. (2004).”
Background
Major depression, temperament, and social support as psychosocial mechanisms of the intergenerational transmission of parenting styles
Abraham, E., Letkiewicz, A. M., WICKRAMARATNE, P. J., Bunyan, M., van Dijk, M. T., Gameroff, M. J., Posner, J. E., Talati, A., & Weissman, M. M. (2021) · Development and Psychopathology · doi:10.1017/s0954579421000420 · Cited by 21
“The validity of the PBI has been supported by many studies showing that subjects’ ratings correlated strongly with the ratings of their parents themselves, siblings, and impartial raters, including observational assessments of parental behavior, regardless of clinical state (Holmbeck et al., 2002; Murphy, Wickramaratn…”
Background
Enhancing Management of Depression and Type 1 Diabetes in Adolescents and Young Adults
Hillege, S. P., Beale, B., & McMaster, R. (2011) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2011.08.003 · Cited by 18
Profiles of Parenting Autonomy Support and Control: A person-Centered Approach in Students’ Adjustment to the Transition to Middle School
Bouffard, T., & Labranche, A.-A. (2022) · The Journal of Early Adolescence · doi:10.1177/02724316221136039 · Cited by 21
“Holmbeck et al. (2002) found that parental overprotection was associated with lower levels of preadolescent decision-making autonomy and less willingness of parents to grant autonomy to their youth.”
Background
“Tell Me About Your Child, The Relationship with Your Child and Your Parental Experiences”: A Qualitative Study of Spontaneous Speech Samples Among Parents Raising a Child with and without Autism Spectrum Disorder, Cerebral Palsy or Down Syndrome
Clercq, L. D., Prinzie, P., Swerts, C., Ortibus, E., & Pauw, S. S. W. D. (2021) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-021-09800-1 · Cited by 20
Discrepancies between mothers and clinicians in assessing functional capabilities and performance of children with cerebral palsy
Elad, D., Barak, S., Eisenstein, E., Bar, O., Givon, U., & Brezner, A. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.07.036 · Cited by 15
The Effect of Perceived Parental Rearing Behaviors on Health-Related Quality of Life in Adolescents with Leukemia
Kim, D. H., Chung, N., & Lee, S. (2015) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454214563412 · Cited by 16
“Holmbeck et al. (2002) suggested that parents of chronically ill children are more protective than parents of healthy children and that overprotection is associated with both depression and “acting out” behaviors in children.”
Background
Improving Transition to Employment for Youth With Physical Disabilities: Protocol for a Peer Electronic Mentoring Intervention
Lindsay, S., Stinson, J., Stergiou‐Kita, M., & Leck, J. (2017) · JMIR Research Protocols · doi:10.2196/resprot.8034 · Cited by 16
“Research consistently shows that parents raising a child with a disability often struggle with encouraging independent skills, especially with self-care and transportation, which are essential elements of work readiness [23-25].”
Background
Parenting and Parent-Child Relationships in Chile
Bush, K. R., & Peterson, G. W. (2013) · Science across cultures · doi:10.1007/978-94-007-7503-9_23 · Cited by 16
Factors associated with parent depressive symptoms and family quality of life in parents of adolescents and young adults with and without Spina Bifida
Ridosh, M. M., Sawin, K. J., Schiffman, R. F., & Klein-Tasman, B. (2016) · Journal of Pediatric Rehabilitation Medicine · doi:10.3233/prm-160399 · Cited by 15
“Research supports the notion that AYA with SB lag 4–5 years behind their peers on autonomy, independence, cognitive processes, and initiative [37,38].”
The role of autonomy-supportive parenting in the competence, adherence and glycemic control of adolescents with type 1 diabetes
Perlberg, M., Katz, I., Loewenthal, N., Kahil, N., Haim, A., Chechik, T., & Hershkovitz, E. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108679 · Cited by 14
Sense of autonomy and daily and scholastic functioning among children with cerebral palsy
Elad, D., Barak, S., Silberg, T., & Brezner, A. (2018) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2018.06.006 · Cited by 16
Family functioning guidelines for the care of people with spina bifida
Kritikos, T. K., & Holmbeck, G. N. (2020) · Journal of Pediatric Rehabilitation Medicine · doi:10.3233/prm-200720 · Cited by 14
“, children with lower IQs have parents who are more controlling) [19].”
BackgroundInfluentialSelf-citation
Quand le parent veut trop bien faire : état de la littérature sur le phénomène de surprotection parentale
Venard, G., Brito, V. P., Eeckhout, P., Zimmermann, G., & Petegem, S. V. (2021) · Psychologie Française · doi:10.1016/j.psfr.2021.11.001 · Cited by 25
Neurobehavioral outcomes in patients with myelomeningocele
Foss, S., Flanders, T. M., Heuer, G. G., & Schreiber, J. E. (2019) · Neurosurgical FOCUS · doi:10.3171/2019.7.focus19445 · Cited by 14
Implications of family environment and language development: comparing typically developing children to those with spina bifida
Vachha, B. A., & Adams, R. (2009) · Child Care Health and Development · doi:10.1111/j.1365-2214.2009.00966.x · Cited by 14
Parenting Styles and Practices in Enhancing Self-Determination of Children With Intellectual and Developmental Disabilities
Meral, B. F., Wehmeyer, M. L., Palmer, S. B., Ruh, A. B., & Yılmaz, E. (2023) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-128.4.282 · Cited by 23
Good overall behavioural adjustment in children and adolescents with classic congenital adrenal hyperplasia
Messina, V., Hirvikoski, T., Karlsson, L., Vissani, S., Wallensteen, L., Ortolano, R., Balsamo, A., Nordenström, A., & Lajić, S. (2020) · Endocrine · doi:10.1007/s12020-020-02244-1 · Cited by 13
Illness Experiences of Adults with Spina Bifida: Protecting the Whole Self
Lim, S.-W., & Yi, M. (2021) · Asian Nursing Research · doi:10.1016/j.anr.2020.12.001 · Cited by 13
Parenting children with food allergy: preliminary development of a measure assessing child-rearing behaviors in the context of pediatric food allergy
Williams, N. A., Parra, G. R., & Elkin, T. D. (2009) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)60167-6 · Cited by 13
Emerging Adult Risky Sexual Behavior Predicted by Parental Overprotection: Moderated Mediation Analysis
Rogers, M. M., & McKinney, C. (2018) · Family Process · doi:10.1111/famp.12394 · Cited by 13
Cultural Considerations for Autonomy and Medical Adherence in a Young Palestinian American Muslim Female With Spina Bifida: A Longitudinal Case Study in a Research Context
Ohanian, D. M., Stiles‐Shields, C., Afzal, K. I., Driscoll, C., Papadakis, J. L., Stern, A., Starnes, M., & Holmbeck, G. N. (2018) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000250 · Cited by 13
Self-citation
Differences in continence rates in individuals with spina bifida based on ethnicity
Smith, K., Liu, T., Freeman, K. A., BETZ, C. L., Clayton, G. H., Castillo, H. A., Castillo, J., Tu, D. D., Speybroeck, A. L. V., & Walker, W. O. (2019) · Journal of Pediatric Rehabilitation Medicine · doi:10.3233/prm-180556 · Cited by 13
“Concepts related to dependency and independence by those with chronic conditions may vary by ethnicity and, therefore, impact the ability to achieve continence [23].”
Longitudinal associations between neuropsychological functioning and medical responsibility in youth with spina bifida: The moderational role of parenting behaviors
Stern, A., Winning, A. M., Ohanian, D. M., Driscoll, C., Starnes, M., Glownia, K., & Holmbeck, G. N. (2020) · Child Neuropsychology · doi:10.1080/09297049.2020.1751098 · Cited by 13
“…acceptance, appropriate parental monitoring, and adequate limit setting) can facilitate the transfer of medical responsibilities to youth, while maladaptive parenting (i.e., harsh, intrusive, and unsupportive) may impede developing responsibility (Holmbeck et al., 2002; Tuminello et al., 2012).”
BackgroundMethodSelf-citation
Pathways by which Maternal Factors are Associated With Youth Spina Bifida-Related Responsibility
Driscoll, C., Ohanian, D. M., Ridosh, M. M., Stern, A., Wartman, E. C., Starnes, M., & Holmbeck, G. N. (2020) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaa020 · Cited by 13
“, 2010; Thomasgard & Metz, 1997), and overprotective behaviors have separately been associated with poorer youth psychosocial and behavioral outcomes in the families of youth with medical conditions (Capelli, McGrath, & MacDonald, 1989; Holmbeck et al., 2002).”
BackgroundInfluentialSelf-citation
Caregivers' attentional bias to pain
Mohammadi, S., Dehghani, M., Khatibi, A., Sanderman, R., & Hagedoorn, M. (2015) · Pain · doi:10.1016/j.pain.0000000000000015 · Cited by 13
Parental readiness for the transition to adulthood of children with a chronic disease
Ozawa, N., Shibayama, T., Hiraga, N., Fukushima, H., Suzuki, R., & Furuya, K. (2023) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2022.12.024 · Cited by 12
Profile and mental health characterization of childhood overprotection/overcontrol experiences among Chinese university students: a nationwide survey
Zhang, J., Wu, Z., Tao, H., Chen, M., Yu, M., Zhou, L., Sun, M., Lv, D., Cui, G., Yi, Q., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1238254 · Cited by 15
Intolerance of uncertainty and protective parenting in mothers of children with food allergy
Steiner, E. M., Dahlquist, L. M., Power, T. G., & Bollinger, M. E. (2019) · Children s Health Care · doi:10.1080/02739615.2019.1650362 · Cited by 12
“Compared to the caregivers of healthy children, caregivers of children with spina bifida reported more intrusive protective behaviors, such as excessive parental control and prevention of the child’s independent behavior (Holmbeck et al., 2002).”
Background
Comparing Cognitive Disengagement Syndrome Growth in Youth With and Without Spina Bifida
Darow, E. L., Flax, M., Clark, O. E., Holmbeck, G. N., & Smith, Z. R. (2023) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsad038 · Cited by 12
Self-citation
The Relationship of Father Parenting Capacity Variables to Perceived Uncertainty in Youth With a Chronic Illness
Ryan, J. L., Ramsey, R. R., Fedele, D. A., Wagner, J. L., Chaney, J. M., & Mullins, L. L. (2011) · Children s Health Care · doi:10.1080/02739615.2011.617237 · Cited by 12
“Therefore, although overprotection may be related to child uncertainty in some chronic illnesses, such as cystic fibrosis and spina bifida (Cappelli et al., 1989; Holmbeck et al., 2002), it may be less salient for others (Mullins et al., 2004; Mullins et al., 2007).”
Background
A Family Perspective: How this Product can Inform and Empower Families of Youth with Spina Bifida
Holmbeck, G. N., Alriksson‐Schmidt, A. I., Bellin, M. H., BETZ, C. L., & Devine, K. A. (2010) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2010.07.012 · Cited by 12
“Specifically, findings revealed that children and adolescents with SB (and especially boys and those with lower levels of intelligence) tend to be more dependent on adults for guidance, less likely to exhibit behavioral autonomy at home, less likely to exhibit intrinsic motivation at school, and less likely to express…”
Self-citation
Prevention of Tobacco Use Among Medically At-risk Children and Adolescents: Clinical and Research Opportunities in the Interest of Public Health
Tercyak, K. P., Britto, M. T., Hanna, K. M., Hollen, P. J., & Hudson, M. M. (2007) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsm132 · Cited by 12
A closer look at the developmental interplay between parenting and perceived health in adolescents with congenital heart disease
Rassart, J., Luyckx, K., Goossens, E., Apers, S., & Moons, P. (2014) · Journal of Behavioral Medicine · doi:10.1007/s10865-014-9569-2 · Cited by 13
Psychosocial outcomes of bone marrow transplant for individuals affected by Mucopolysaccharidosis I Hurler Disease: patient social competency
Pitt, C., Lavery, C., & Wager, N. (2009) · Child Care Health and Development · doi:10.1111/j.1365-2214.2008.00918.x · Cited by 11
The experiences and needs of individuals with disabilities exposed to chronic political violence
Shpigelman, C., & Gelkopf, M. (2016) · Disability and Rehabilitation · doi:10.3109/09638288.2016.1138557 · Cited by 12
“Overprotection is a well-known phenomenon in a family where a child has a disability.[84,85] Caretakers of children with disabilities might be overprotective to shield them from harm; however, this has the potential to cause more damage in terms of low self-esteem and the development of fewer skills, which are usually…”
Background
Exploring Parental Factors Related to Weight Management in Survivors of Childhood Central Nervous System Tumors
Maria, D. S., Swartz, M. C., Markham, C. M., Chandra, J., McCurdy, S., & Basen-Engquist, K. M. (2014) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454213518112 · Cited by 11
“Children and parents both described a child’s difficulty in relating to his or her peer group in contrast to the comfort level the child felt with adults, further pointing to possible negative psychosocial adjustment related to parental overprotection (Holmbeck et al., 2002).”
Background
Influence of parental care on offspring hippocampal volume in young adults varies as a function of overprotection
Wang, Y., Song, Y., Li, X., Zhang, L., & Liu, J. (2017) · Scientific Reports · doi:10.1038/srep46429 · Cited by 11
Youth and Parent Health-Related Quality of Life and Association With Glycemic Outcomes in Preadolescents and Adolescents With Type 1 Diabetes
Totka, J. P., Snethen, J., & COX, E. D. (2020) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2020.07.015 · Cited by 11
The relationship of child executive functions to parenting capacities in childhood acute lymphoblastic leukemia survivors
Sharkey, C. M., Clawson, A. H., Mullins, L. L., Brinkman, T. M., Pui, C., Hudson, M. M., & Krull, K. R. (2019) · Pediatric Blood & Cancer · doi:10.1002/pbc.27761 · Cited by 11
Nightmare experience and family relationships in healthy volunteers and nightmare disorder patients
Wang, C., Shao, X., Jia, Y., Shen, C., & Wang, W. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2299-9 · Cited by 11
Self-Compassion in Parenting
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Authors: Holmbeck, G. N., Johnson, S. Z., Wills, K. E., McKernon, W., Rose, B., Erklin, S., & Kemper, T.
Affiliations: Loyola University Chicago (US)
ORCID: Holmbeck, Grayson N.
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2002
Volume: 70
Issue: 1
Pages: 96-110
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/0022-006x.70.1.96
OpenAlex: W2135416944
Cited by: 353
References: 103
Citations by year: 2026: 9 · 2025: 5 · 2024: 11 · 2023: 20 · 2022: 16 · 2021: 18 · 2020: 12 · 2019: 20 · 2018: 17 · 2017: 19 · 2016: 15 · 2015: 19 · 2014: 27 · 2013: 15 · 2012: 20
FWCI: 10.15
Type: journal article
Language: en
Open access: closed
Locations: Journal of Consulting and Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Developmental and Educational Psychology › Psychosocial Factors Impacting Youth
Keywords: parental overprotection, behavioral autonomy, psychosocial adjustment, preadolescents, spina bifida, physical disability, externalizing problems, cognitive ability, gender differences in parenting, mediation, decision-making autonomy, parenting
MeSH terms: Adaptation, Psychological, Child, Female, Humans, Male, Parent-Child Relations, Social Adjustment, Spinal Dysraphism, Parenting, Observation, Children with Disabilities, Disabled Children, Personal Autonomy

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Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: The mediational role of behavioral autonomy

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