Systematic review of the link between maternal anxiety and overprotection

Highlights

• Reviewed studies of the relation between maternal anxiety and overprotection.

• Thirteen studies met inclusion criteria.

• Evidence supported a small to medium size effect for the relation.

• Maternal anxiety is one factor accounting for variance in overprotection.

Abstract

Background

Theoretical and empirical evidence suggests that maternal anxiety relates to overprotection, yet studies have found conflicting evidence. The literature would benefit from a systematic review.

Methods

In April 2020, a systematic review on the relation between maternal anxiety and overprotection was conducted. The search was updated in January 2021. A total of 13 articles were included.

Results

Of 16 reported bivariate correlations, 12 showed that maternal anxiety accounted for significant variance in overprotection (7 reported a small effect and 5 reported a medium effect). In a group differences study, mothers with anxiety showed greater overprotection. Additionally, in 4 out of 7 multivariate relations maternal anxiety accounted for significant variance in overprotection over and above other factors while 3 suggested that maternal anxiety did not account for significant variance in overprotection. In a multivariate, longitudinal study, maternal anxiety predicted overprotection, over and above other factors. Given conflicting evidence, we evaluated article's methodological strength and found stronger evidence supporting a small to medium size relation compared to evidence supporting no significant relation.

Limitations

We report ranges of coefficients and effect sizes, but meta-analytic results are needed to determine the magnitude of these relations based on various factors. More longitudinal studies are needed to determine directionality.

Conclusions

Although the literature shows conflicting results, the present review supports that maternal anxiety relates to overprotection, though the effect of this relation is small to medium. It may be beneficial to incorporate mental health for parents into existing parenting interventions.

Introduction

Overprotective parenting, a parenting behavior falling under the larger umbrella of over-controlling parenting, has often been implicated in the development of child anxiety disorders and symptoms (Bögels & van Melick, 2004; Creveling et al., 2010; Nishikawa et al., 2010). Anxiety disorders and symptoms are prevalent in childhood and persist into adulthood (Costello et al., 2005; Ghandour et al., 2019). To develop effective interventions for families who have children with or at risk for anxiety, it is essential to understand factors that may predict parenting behaviors that heighten children's anxiety symptoms.

Despite a robust body of literature showing the negative effects of overprotective parenting (Costa & Weems, 2005; Creveling et al., 2010; Nishikawa et al., 2010; Reitman & Asseff, 2010), little research has identified factors that contribute to these behaviors. Maternal characteristics, such as maternal anxiety, may relate to greater use of overprotection (Bögels & van Melick, 2004; Clarke et al., 2013; Root et al., 2016). Research has identified theoretical and empirical evidence for this relation (Bögels & van Melick, 2004; Clarke et al., 2013; Root et al., 2016), but the literature also shows conflicting evidence (Ginsburg et al., 2004; Manassis & Bradley, 1994; Moore et al., 2004). It is imperative that we understand if there is enough empirical evidence to support the link between maternal anxiety and overprotection to inform future research and design effective clinical interventions. Therefore, the present review will systematically evaluate the evidence for the link between maternal anxiety and overprotection and propose avenues for future research.

Overprotection is defined as unnecessarily supportive and warm parenting behaviors that limit children's opportunities to cope independently with developmentally appropriate challenges (Chorpita & Barlow, 1998; Rubin et al., 1997). These behaviors can jeopardize children's sense of mastery over their environment, decreasing their self-competence, and fostering dependence on the caregiver (Affrunti & Ginsburg, 2012; Chorpita & Barlow, 1998; Hudson & Rapee, 2004; Wood, 2006). Additionally, overprotection can communicate to children that the world is a dangerous place, encourage and reinforce avoidance, and limit children's chances to approach challenges that can foster confidence and skill building (Chorpita & Barlow, 1998; Rapee, 1997). In order to improve the mental health of children and families, it is important to study and prevent overprotective behaviors in environments where children are faced with developmentally appropriate challenges.

Several decisions were made when determining the criteria for the current review. First, we focused our search on overprotection rather than on autonomy granting because previous research suggests that these variables may be distinct constructs rather than opposite ends of a continuum (Silk et al., 2003) and the literature has shown inconsistent correlations between autonomy granting and overprotection (Holmbeck et al., 2002). Second, we limited our search to overprotection in mothers of infants, toddlers, and children (i.e., aged approximately 0-12 years old) because overprotection may play a particularly important role in earlier years when the family environment is a dominant source of influence on development (Baumrind, 1967). Finally, we studied overprotection in mothers as the majority of research on parenting related to child anxiety has tested the influence of maternal parenting (Bögels & Phares, 2008), despite growing literature supporting the importance of fathers and other caregivers on development.

Maternal anxiety may be a trait that is relevant to maternal overprotection, as mothers with anxiety may engage in overprotective parenting as a way of decreasing their own distress (Turner et al., 2003). Additionally, mothers with anxiety may engage in overprotection because of a greater tendency to perceive threats to their children in the environment (Lindhout et al., 2006). Cognitive theories for anxiety suggest that anxiety leads to a narrowing of attention and an attentional bias towards threat (Becker et al., 2001; Najmi et al., 2012). Additionally, individuals with anxiety show hypervigilance, in which an individual scans the environment for threats, resulting in a greater likelihood of detecting potentially threatening cues in the environment (Eysenck, 1992). Indeed, numerous studies have found that maternal anxiety is related to greater use of overprotection (Bögels & van Melick, 2004; Clarke et al., 2013; Root et al., 2016). However, the literature also shows conflicting evidence for this relation (Ginsburg et al., 2004; Manassis & Bradley, 1994; Moore et al., 2004), suggesting the need to systematically review the literature on the relation between maternal anxiety and overprotection in order to determine whether the relation is robust.

Despite numerous studies testing the link between maternal anxiety and overprotection, a systematic review of these studies has not been conducted. A meta-analysis testing the relation between parent anxiety and parental over-control was conducted, but no studies examining overprotection were included (van der Bruggen et al., 2008). Instead, the authors included articles testing parental control, psychological control, negative control, parental control involvement, intrusiveness, command, watching or controlling, restriction, and granting of autonomy. Although some aspects of overprotection may be captured in these constructs, authors have argued that within the broader construct of parental control, overprotection is especially influential in child anxiety development because it encourages an avoidant coping style (Hudson & Rapee, 2004; Rubin et al., 2009). Thus, overprotection must be studied, specifically.

Research also suggests that children are active contributors to the parenting they receive (Dadds & Roth, 2001). Although not the focus of the present review, it is important to note that parenting takes place in an interaction between the parent and the child. Thus, maternal anxiety likely will not explain all of the variance in overprotection. However, determining if maternal anxiety is one of the robust predictors of overprotection is necessary to move the literature forward and effectively develop interventions for overprotection and child anxiety development.

Although current literature theorizes that maternal anxiety contributes to greater use of overprotective parenting behaviors, it is unclear whether this relation has substantial empirical support. Therefore, the aim of the current review is to systematically evaluate the existing literature on the relation between maternal anxiety and overprotection. Specifically, this review will (1) evaluate empirical studies that report statistics on the association between maternal anxiety and overprotective parenting and (2) discuss strengths and limitations of the current literature, providing directions for future research to advance our understanding of the influence of maternal anxiety and overprotection.