Skip to main content
Log in

Perceived Parental Rearing in Paediatric Obsessive–Compulsive Disorder: Examining the Factor Structure of the EMBU Child and Parent Versions and Associations with OCD Symptoms

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

Parental rearing behaviours characterised by high levels of rejection and overprotection have been implicated in the development and maintenance of child psychopathology, including paediatric obsessive–compulsive disorder (OCD). The Egna Minnen Beträffande Uppfostran (EMBU) is a commonly used measure of perceived parental rearing. Using confirmatory factor analysis, the factor structure of the EMBU child and parent versions were examined in a sample of children and youth with OCD (n = 176), and their mothers (n = 162). Associations between rearing and clinical correlates of OCD were explored. For parents, a 4-factor model provided the best fit. For children, a higher order model was the best fit. Greater parent and child perceived negative rearing behaviours and lower perceived positive behaviours were associated with greater OCD severity, comorbid symptoms and impairment. The EMBU has a conceptually meaningful factor structure and provides a useful measure for assessing perceived rearing behaviours within paediatric OCD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bögels SM, Brechman-Toussaint ML (2006) Family issues in child anxiety: Attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev 26:834–856

    PubMed  Google Scholar 

  2. Bögels SM, Phares V (2008) Fathers' role in the etiology, prevention and treatment of child anxiety: a review and new model. Clin Psychol Rev 28:539–558

    PubMed  Google Scholar 

  3. Brander G, Pérez-Vigil A, Larsson H, Mataix-Cols D (2016) Systematic review of environmental risk factors for obsessive-compulsive disorder: a proposed roadmap from association to causation. Neurosci Biobehav Rev 65:36–62

    PubMed  Google Scholar 

  4. McLeod BD, Wood JJ, Weisz JR (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27:155–172

    PubMed  Google Scholar 

  5. Möller EL, Nikolić M, Majdandžić M, Bögels SM (2016) Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: a meta-analysis. Clin Psychol Rev 45:17–33

    PubMed  Google Scholar 

  6. Murray L, Creswell C, Cooper PJ (2009) The development of anxiety disorders in childhood: an integrative review. Psychol Med 39:1413–1423

    PubMed  Google Scholar 

  7. Rapee RM (1997) Potential role of childrearing practices in the development of anxiety and depression. Clin Psychol Rev 17:47–67

    PubMed  Google Scholar 

  8. Schleider JL, Weisz JR (2017) Family process and youth internalizing problems: a triadic model of etiology and intervention. Dev Psychopathol 29:273–301

    PubMed  Google Scholar 

  9. Van Der Bruggen CO, Stams GJJM, Bögels SM (2008) Research review: the relation between child and parent anxiety and parental control: a meta-analytic review. J Child Psychol Psychiatry 49:1257–1269

    PubMed  Google Scholar 

  10. Wood JJ, McLeod BD, Sigman M, Hwang WC, Chu BC (2003) Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry 44:134–151

    PubMed  Google Scholar 

  11. Piacentini J, Bergman RL, Keller M, McCracken J (2003) Functional impairment in children and adolescents with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 13:61–69

    Google Scholar 

  12. Storch EA, Lehmkuhl H, Pence SL, Geffken GR, Ricketts E, Storch JF, Murphy TK (2009) Parental experiences of having a child with obsessive-compulsive disorder: associations with clinical characteristics and caregiver adjustment. J Child Fam Stud 18:249–258

    Google Scholar 

  13. Valderhaug R, Ivarsson T (2005) Functional impairment in clinical samples of Norwegian and Swedish children and adolescents with obsessive-compulsive disorder. Eur Child Adolesc Psychiatry 14:164–173

    PubMed  Google Scholar 

  14. Alonso P, Menchón JM, Mataix-Cols D, Pifarré J, Urretavizcaya M, Crespo JM, Jiménez S, Vallejo G, Vallejo J (2004) Perceived parental rearing style in obsessive–compulsive disorder: relation to symptom dimensions. Psychiatry Res 127:267–278

    PubMed  Google Scholar 

  15. Barrett P, Shortt A, Healy L (2002) Do parent and child behaviours differentiate families whose children have obsessive-compulsive disorder from other clinic and non-clinic families? J Child Psychol Psychiatry 43:597–607

    PubMed  Google Scholar 

  16. Lennertz L, Grabe HJ, Ruhrmann S, Rampacher F, Vogeley A, Schulze-Rauschenbach S, Ettelt S, Meyer K, Kraft S, Reck C, Pukrop R (2010) Perceived parental rearing in subjects with obsessive–compulsive disorder and their siblings. Acta Psychiatr Scand 121:280–288

    PubMed  Google Scholar 

  17. Mathieu S, Farrell L, Waters A, Lightbody J (2015) An observational study of parent–child behaviours in paediatric OCD: examining the origins of inflated responsibility. J Obsessive Compuls Relat Disord 6:132–143

    Google Scholar 

  18. Przeworski A, Zoellner LA, Franklin ME, Garcia A, Freeman J, March JS, Foa EB (2012) Maternal and child expressed emotion as predictors of treatment response in pediatric obsessive–compulsive disorder. Child Psychiatry Hum Dev 43:337–353

    PubMed  PubMed Central  Google Scholar 

  19. Smári J, Martinsson DR, Einarsson H (2010) Rearing practices and impulsivity/hyperactivity symptoms in relation to inflated responsibility and obsessive-compulsive symptoms. Scand J Psychol 51:392–397

    PubMed  Google Scholar 

  20. Turgeon L, O'Connor KP, Marchand A, Freeston MH (2002) Recollections of parent–child relationships in patients with obsessive-compulsive disorder and panic disorder with agoraphobia. Acta Psychiatr Scand 105:310–316

    PubMed  Google Scholar 

  21. DiBartolo PM, Grills AE (2006) Who is best at predicting children’s anxiety in response to a social evaluative task? A comparison of child, parent, and teacher reports. J Anxiety Disord 20:630–645

    PubMed  Google Scholar 

  22. Bögels SM, van Melick M (2004) The relationship between child-report, parent self-report, and partner report of perceived parental rearing behaviors and anxiety in children and parents. Pers Individ Differ 37:1583–1596

    Google Scholar 

  23. Korelitz KE, Garber J (2017) Congruence of parents’ and children’s perceptions of parenting: a meta-analysis. J Youth Adolesc 45:1973–1995

    Google Scholar 

  24. Gerlsma C, Snijders T, van Duijn M, Emmelkamp P (1997) Parenting and psychopathology: differences in family members' perceptions of parental rearing styles. Pers Individ Differ 23:271–282

    Google Scholar 

  25. Valentiner DP, Mounts NS (2017) Method variance in adolescents’, mothers’, and observers’ reports or peer management: nuisance or information? J Youth Adolesc 46:1038–1056

    PubMed  Google Scholar 

  26. Gardner F (2000) Methodological issues in the direct observation of parent-child interaction: do observational findings reflect the natural behavior of participants? Clin Child Fam Psychol Rev 3:185–198

    PubMed  Google Scholar 

  27. Ginsburg GS, Grover RL, Cord JJ, Ialongo N (2006) Observational measures of parenting in anxious and non-anxious mothers: does type of task matter? J Clin Child Adolesc Psychol 35:323–328

    PubMed  PubMed Central  Google Scholar 

  28. Gonzalez A, Moore PS, Garcia AM, Thienemann M, Huffman L (2011) Activation during observed parent-child interactions with anxious youths: a pilot study. J Psychopathol Behav Assess 33:159–170

    PubMed  PubMed Central  Google Scholar 

  29. Young B, Wallace D, Imig M, Borgerding L, Brown-Jacobsen A, Whiteside S (2013) Parenting behaviors and childhood anxiety: a psychometric investigation of the EMBU-C. J Child Fam Stud 22:1138–1146

    Google Scholar 

  30. Arrindell WA, Perris C, Eisemann M, Perris H, Van der Ende J, Ross M et al (1986) Cross-national generalizability of patterns of parental rearing behaviour: Invariance of EMBU dimensional representations of healthy subjects from Australia, Denmark, Hungary, Italy and The Netherlands. Pers Individ Differ 7:103–112

    Google Scholar 

  31. Castro J, Toro J, Van der Ende J, Arrindell WA (1993) Exploring the feasibility of assessing perceived parental rearing styles in Spanish children with Theembu. Int J Soc Psychiatry 39:47–57

    PubMed  Google Scholar 

  32. Gerlsma C, Arrindell WA, Van der Veen N, Emmelkamp PM (1991) A parental rearing style questionnaire for use with adolescents: psychometric evaluation of the EMBU-A. Pers Individ Differ 12:1245–1253

    Google Scholar 

  33. Castro J, de Pablo J, Gómez J, Arrindell WA, Toro J (1997) Assessing rearing behaviour from the perspective of the parents: a new form of the EMBU. Soc Psychiatry Psychiatr Epidemiol 32:230–235

    PubMed  Google Scholar 

  34. Muris P, Meesters C, van Brakel A (2003) Assessment of anxious rearing behaviors with a modified version of “Egna Minnen Beträffande Uppfostran” Questionnaire for children. J Psychopathol Behav Assess 25:229–237

    Google Scholar 

  35. Aluja A, Del Barrio V, Garcia LF (2006) Comparison of several shortened versions of the EMBU: exploratory and confirmatory factor analyses. Scand J Psychol 47:23–31

    PubMed  Google Scholar 

  36. Garcia OF, Serra E, Zacares JJ, Calafat A, Garcia F (2019) Alcohol use and abuse and motivations for drinking and non-drinking among Spanish adolescents: do we know enough when we know parenting style? Psychol Health 11:1–20

    Google Scholar 

  37. Steinberg L (2001) We know some things: parent-adolescent relationships in retrospect and prospect. J Res Adolesc 11:1–19

    Google Scholar 

  38. Muris P, Bögels S, Meesters C, van der Kamp N, van Oosten A (1996) Parental rearing practices, fearfulness, and problem behaviour in clinically referred children. Pers Individ Differ 21:813–818

    Google Scholar 

  39. Penelo E, Viladrich C, Domènech JM (2010) Perceived parental rearing style in childhood: internal structure and concurrent validity on the Egna Minnen Beträffande Uppfostran—child version in clinical settings. Compr Psychiatry 51:434–442

    PubMed  Google Scholar 

  40. Grüner K, Muris P, Merckelbach H (1999) The relationship between anxious rearing behaviours and anxiety disorders symptomatology in normal children. J Behav Ther Exp Psychiatry 30:27–35

    PubMed  Google Scholar 

  41. Muris P, Bosma H, Meesters C, Schouten E (1998) Perceived parental rearing behaviours: a confirmatory factor analytic study of the Dutch EMBU for children. Pers Individ Differ 24:439–442

    Google Scholar 

  42. van Brakel AM, Muris P, Bögels SM, Thomassen C (2006) A multifactorial model for the etiology of anxiety in non-clinical adolescents: main and interactive effects of behavioral inhibition, attachment and parental rearing. J Child Fam Stud 15:568–578

    Google Scholar 

  43. Meesters C, Muris P (2004) Perceived parental rearing behaviours and coping in young adolescents. Pers Individ Differ 37:513–522

    Google Scholar 

  44. Brown AM, Whiteside SP (2008) Relations among perceived parental rearing behaviors, attachment style, and worry in anxious children. J Anxiety Disord 22:263–327

    PubMed  Google Scholar 

  45. Mathieu SL, Conlon EG, Waters AM, McKenzie ML, Farrell LJ (2019) Inflated responsibility beliefs in paediatric OCD: exploring the role of parental rearing and child age. Child Psychiatry & Hum Dev. https://doi.org/10.1007/s10578-019-00938-w

    Article  Google Scholar 

  46. Silverman WK, Albano AM (1996) Anxiety disorders interview schedule IV: parent interview schedule. Oxford University Press, New York

    Google Scholar 

  47. Scahill L, Riddle M, McSwiggin-Hardin M, Ort SI, King RA, Goodman W et al (1997) Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852

    Google Scholar 

  48. Lewin A, Piacentini J (2010) Evidence-based assessment of child obsessive compulsive disorder: recommendations for clinical practice and treatment research. Child Youth Care Forum 39:73–89

    PubMed  PubMed Central  Google Scholar 

  49. Farrell LJ, Mathieu SL, Lavell CH (2018) 22 Obsessive–compulsive and related disorders. In: Ollendick TH, White SW, White BA (eds) The Oxford Handbook of clinical child and adolescent psychology. Oxford University Press, Oxford, pp 308–309

    Google Scholar 

  50. Rapp A, Bergman R, Piacentini J, Mcguire J (2016) Evidence-based assessment of obsessive-compulsive disorder. J Cent Nerv Syst Dis 8:13–29

    PubMed  PubMed Central  Google Scholar 

  51. Piacentini J, Jaffer M (1999) Measuring functional impairment in youngsters with OCD: manual for the Child OCD Impact Scale (COIS). UCLA Department of Psychiatry, Los Angeles

    Google Scholar 

  52. Storch EA, Larson MJ, Muroff J, Caporino N, Geller D, Reid JM et al (2010) Predictors of functional impairment in pediatric obsessive-compulsive disorder. J Anxiety Disord 24:275–283

    PubMed  Google Scholar 

  53. Kovacs M (2011) MHS staff children’s depression inventory (CDI-2), 2nd edn. Multi-Health Systems MHS, North Tanawanda

    Google Scholar 

  54. Achenbach TM, Edelbrock CS (1983) Manual for the child behavior checklist: and revised child behavior profile. University of Vermont Department of Psychiatry, Burlington

    Google Scholar 

  55. Achenbach TM, Dumenci L, Rescorla LA (2001) Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR. University of Vermont Department of Psychiatry, Burlington

    Google Scholar 

  56. Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther 33:335–343

    PubMed  Google Scholar 

  57. Sinclair SJ, Siefert CJ, Slavin-Mulford JM, Stein MB, Renna M, Blais MA (2012) Psychometric evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of US adults. Eval Health Prof 35:259–279

    PubMed  Google Scholar 

  58. Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview Schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40:937–944

    PubMed  Google Scholar 

  59. Lyneham HJ, Rapee RM (2005) Agreement between telephone and in-person delivery of a structured interview for anxiety disorders in children. J Am Acad Child Adolesc Psychiatry 44:274–282

    PubMed  Google Scholar 

  60. Waters AM, Zimmer-Gembeck MJ, Farrell LJ (2012) The relationships of child and parent factors with children's anxiety symptoms: parental anxious rearing as a mediator. J Anxiety Disord 26:737–745

    PubMed  Google Scholar 

  61. Hau KT, Marsh HW (2004) The use of item parcels in structural equation modelling: non-normal data and small sample sizes. Br J Math Stat Psychol 57:327–351

    PubMed  Google Scholar 

  62. Little TD, Rhemtulla M, Gibson K, Schoemann AM (2013) Why the items versus parcels controversy needn’t be one. Psychol Methods 18:285

    PubMed  PubMed Central  Google Scholar 

  63. Kline RB (2016) Principles and practice of structural equation modeling, 4th edn. Guilford Press, New York

    Google Scholar 

  64. Bentler PM, Bonett DG (1980) Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull 88:588

    Google Scholar 

  65. Hu LT, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model 6:1–55

    Google Scholar 

  66. Lavell CH, Farrell LJ, Waters AM, Cadman J (2016) Predictors of treatment response to group cognitive behavioural therapy for pediatric obsessive-compulsive disorder. Psychiatry Res 245:186–193

    PubMed  Google Scholar 

  67. Meyer A, Proudfit GH, Bufferd SJ, Kujawa AJ, Laptook RS, Torpey DC et al (2015) Self-reported and observed punitive parenting prospectively predicts increased error-related brain activity in six-year-old children. J Abnorm Child Psychol 43:821–829

    PubMed  PubMed Central  Google Scholar 

  68. Riskind JH, Wright EC, Scott M (2018) Anticipated criticism/rejection and negative self-appraisals: do they independently predict OCD symptoms and the negative significance of intrusive thoughts? Int J Cogn Ther 11:4–16

    Google Scholar 

  69. Futh A, Simonds LM, Micali N (2012) Obsessive-compulsive disorder in children and adolescents: parental understanding, accommodation, coping and distress. J Anxiety Disord 26:624–632

    PubMed  Google Scholar 

  70. Abidin RR (1992) The determinants of parenting behaviour. J Clin Child Psychol 21:407–412

    Google Scholar 

  71. Moed A, Dix T, Anderson ER, Greene SM (2017) Expressing negative emotions to children: mothers’ aversion sensitivity and children’s adjustment. J Fam Psychol 31:224

    PubMed  Google Scholar 

  72. Neece CL, Green SA, Baker BL (2012) Parenting stress and child behavior problems: a transactional relationship across time. Am J Intellect Dev Disabil 117:48–66

    PubMed  PubMed Central  Google Scholar 

  73. Lebowitz ER, Storch EA, MacLeod J, Leckman JF (2015) Clinical and family correlates of coercive–disruptive behavior in children and adolescents with obsessive–compulsive disorder. J Child Fam Stud 24:2589–2597

    Google Scholar 

  74. Wu MS, Hamblin R, Nadeau J, Simmons J, Smith A, Wilson M et al (2018) Quality of life and burden in caregivers of youth with obsessive-compulsive disorder presenting for intensive treatment. Compr Psychiatry 80:46–56

    PubMed  Google Scholar 

  75. Markus MT, Lindhout IE, Boer F, Hoogendijk TH, Arrindell WA (2003) Factors of perceived parental rearing styles: the EMBU-C examined in a sample of Dutch primary school children. Pers Individ Differ 34:503–519

    Google Scholar 

  76. Lindhout IE, Markus MT, Borst SR, Hoogendijk TH, Dingemans PM, Boer F (2009) Childrearing style in families of anxiety-disordered children: between-family and within-family differences. Child Psychiatry Hum Dev 40:197–212

    PubMed  Google Scholar 

Download references

Funding

Data comprised in this study was partially supported by funding from the NHMRC Australia, FMFC Australia, and the Australian Postgraduate Award. The funding bodies had no role in the study design or execution, nor were they involved in the submission process.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sharna L. Mathieu.

Ethics declarations

Conflict of interest

The authors declare no further conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mathieu, S.L., Conlon, E.G., Waters, A.M. et al. Perceived Parental Rearing in Paediatric Obsessive–Compulsive Disorder: Examining the Factor Structure of the EMBU Child and Parent Versions and Associations with OCD Symptoms. Child Psychiatry Hum Dev 51, 956–968 (2020). https://doi.org/10.1007/s10578-020-00979-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-020-00979-6

Keywords

Navigation