Measurement of Parenting Styles and their Relationship to Well-Being in Saudi Arabia

Ahmed M. Alkhalaf^*

Family and Community Medicine Department, Faculty of Medicine, AlBaha University, Saudi Arabia

*Corresponding Author:

Ahmed M. Alkhalaf
Family and Community Medicine Department
Faculty of Medicine, AlBaha University, Saudi Arabia
E-mail: ahmadalkhalaf@hotmail.co.uk

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Abstract

Objective: The purpose of this research was to validate the a new tool for assessing parenting behavior in Arab populations (specifically in Saudi Arabia), examine the assessment’s relationships with existing measures of well-being, and test the hypothesis that abuse predicts only negative affect and encouragement only positive affect.

Methods: The seven-item Arabic Parenting Style Questionnaire (APSQ) assesses Abuse and Encouragement in Saudi Arabian parent-child relationships. The APSQ and other assessments were administered to Saudi Arabian adult participants (Study 1, N = 249; Study 2, N = 293), and their responses were analyzed using correlational and regression analyses.

Results: The Abuse and Encouragement subscales of the APSQ showed good factorial discrimination and acceptable internal consistency (α = 0.75 to 0.86), and were weakly correlated (r = -0.20). Encouragement was positively correlated (r = 0.43) with the Authoritative subscale of the Parental Authority Questionnaire (PAQ). Subscales of the PAQ and APSQ predicted independent variance of Global Quality of Life (GQOL). Abuse and Encouragement both independently predicted GQOL and Satisfaction with Life Scale (SWLS), but only Abuse independently predicted negative affect, and only Encouragement predicted positive affect.

Conclusions: Individuals who reported having experienced any abusive parenting, not just extreme abuse, reported decreased well-being long into adulthood, indicating that even parenting practices that may not be seen as abuse can have long-term, negative consequences.

Keywords

Arab, parenting style, child abuse, encouragement, well-being

Abbreviations

(APSQ) Arabic Parenting Style Questionnaire

Introduction

In Saudi Arabia, shouting at and beating children are socially sanctioned forms of discipline in the home, and corporal punishment is a common form of discipline in schools (Achoui, 2003, 2006; Dwairy, 2006; Long, 2005). These parenting practices are not only socially endorsed and statistically frequent, but also accepted by adolescents without complaint in Saudi Arabia and other Gulf countries (Hatab & Makki, 1978). Although one might automatically assume that parenting practices considered abusive by other cultures are universally harmful, that is not necessarily the case. There is some evidence that the effects of parenting styles vary across cultures (for a review, see Dwairy et al., 2006).

Cross-cultural differences in the impact of parenting styles primarily concern the effect of authoritarian parenting, or parenting in which the child is expected to obey a parent’s orders simply because the parent is an authority figure. This parenting style is measured by the Authoritarian subscale of the Parenting Authority Questionnaire (PAQ; Buri, 1991). A typical item from the PAQ’s Authoritarian subscale is, “As I was growing up I knew what my father expected of me in the family and he insisted that I conform to those expectations simply out of respect for his authority.” Authoritarian parenting is associated with poor mental health in Western countries, but that relationship is non-existent or very weak in Asian and Arab countries (Dwairy et al., 2006). It is hypothesized that authoritarian parenting has no association with or only a weak negative association with mental health outcomes in Asian and Arab societies because authoritarian parenting is the norm and is accepted by children and by society. Nonetheless, authoritative parenting, which is characterised by a rational, reasoned approach to discipline, is associated with better mental health in all cultures (Dwairy et al., 2006). The PAQ also include an Authoritative subscale, and a representative item from this subscale is, “My mother always encouraged verbal give-and-take whenever I felt that family rules and restrictions were unreasonable.”

Abusive parenting differs from authoritarian and authoritative parenting not in terms of the criteria for discipline, but rather in terms of the way that discipline is imposed. Abusive parenting is characterised by a correctional method that is harsh and may be demeaning to the child, such as physical punishment or verbal aggression (e.g., shouting at, criticising the child). In the West, such treatment leads to poor mental health (Felitti et al., 1998; Gibb et al., 2007; Kendler et al., 2000; Kessler et al., 1997; Levitan et al., 2003; MacMillan et al., 2001; McCauley et al., 1997; Moeller et al., 1993; Safren et al., 2002; Walker et al., 1999). However, although general abuse is considered binary, abusive parenting involves a gradation in parenting style that ranges from extremely abusive to not at all abusive.

Research into the effects of abusive parenting in traditional Arab countries is hampered by the lack of a validated, culturally appropriate scale. In addition to verbal abuse (e.g., criticism) and physical abuse (e.g., beating), lack of encouragement is a characteristic of the traditional Arabic parenting style (Dwairy et al., 2006) but is not a common focus of parenting scales. The first focus of this paper is the development and validation of a culturally appropriate parenting style scale that taps into abusive parenting as well as encouragement of children. The Arabic Parenting Style Questionnaire (APSQ) was specifically designed to fill this niche and was written in Arabic, thus avoiding issues of cultural adaptation and linguistic translation. The APSQ is intended as a brief tool for collecting retrospective reports of parenting behaviors for use in epidemiological studies (Appendix A).

Once the APSQ has been determined to be psychometrically sound, preliminary steps are taken to address whether parenting behaviors described as “abusive” are less harmful in Arab society. Specifically, are beating and insulting children less harmful to the children’s long-term mental health in Arab Society, where such behaviors are socially sanctioned, common, and accepted by children? This issue is examined in Saudi Arabia specifically and through exploration of the relationship between the APSQ and established measures of well-being.

Knowing that childhood experiences, such as abuse, have long-term impact on individuals’ mental health and well-being, a secondary question is through what mechanism or process that impact occurs. Determining this process might facilitate an understanding of how individuals in some cultures seem more impacted by parenting behaviors than individuals in other cultures. Infornet theory, a network theory that integrates biology and psychology (Hyland, 2011), provides a guide for consideration of this question. Trait negative and positive affect correlate with and independently predict well-being (Diener & Chan, 2011). Negative and positive affect have little to no correlation, suggesting they arise from two different mechanisms (Watson, 1988; Watson et al., 1988). Reinforcement sensitivity theory is a biologically validated theory showing that organisms vary in the extent to which they are sensitive to punishment versus reward (Corr, 2008). Infornet theory suggests a relationship among these theories of affect and reinforcement sensitivity theory (Hyland, 2011). If a young, plastic network operates with the associative learning rule (the basis for learning) and is exposed to repeated punishment, then the network will gradually become more sensitive to punishment and increase in negative affect. In contrast, if the network is repeatedly exposed positive or successful novel experiences, then reward sensitivity and positive affect will increase. Based on infornet theory (Hyland, 2011), abuse in early childhood (the young network) should lead to an increase in negative but not positive affect, whereas encouragement should lead to an increase in positive but not negative affect. The final aim of these studies was to test this prediction.

Questionnaire Construction

The seven-item APSQ was constructed using a multi-step procedure. First, an initial list of 10 items was compiled on the basis of previous literature on child-rearing in Saudi society (Al Ayed et al., 1998; Al Eissa, 1991; Al Eissa & Almuneef, 2010; Al-Jumaah et al., 1993; Al-Mahroos, 2007; Al Mugeiren & Ganelin, 1990). Two separate focus groups (Group 1, N = 13 men; Group 2, N = 7 women; held in Saudi Arabia and segregated by sex for cultural reasons) were asked to discuss and give feedback on the questionnaire. In this and all studies presented in this work, participants gave informed consent and the studies were deemed ethical by University of Plymouth’s Human Ethics Committee and were consistent with the Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving human subjects. Based on participants’ comments, seven items were added to the questionnaire, increasing the number of items to 17.

The 17-item version of the questionnaire was administered to 548 male and female Saudi students (442 males; 106 females) studying in the United Kingdom (UK). These participants were also asked, “Did your parents keep something (e.g., a stick) for beating you?” A total of 118 participants (21.5% of the sample), 94 males and 24 females, responded “yes” to this question. This sample was recruited in UK where the author was conducting his PhD in UK then. The fact that they represent people from all of Saudi Arabia it was thought that it should have reasonable representation of the country and reduces biasness of regions and social background etc. As such the biasness is only limited to people being abroad but still all Saudis and from all KSA. The youth group should have relatively recent experiences of their parental style, and not contaminated too much by very old memories.

Exploratory factor analysis (EFA) of responses from these 548 participants to the 17-item questionnaire led to the selection of seven items, four related to parents’ abusive behaviors and three related to parents’ discouraging their children from expressing their thoughts, feelings, or ideas. Items with high loadings on these two factors (named Abuse and Encouragement) were retained. The resulting seven items comprise the two subscales of the APSQ (the original Arabic questionnaire is available upon request). Instructions direct respondents to rate each item on an eight-point Likert scale indicating how frequently their parents behaved in the way described in the item (1 = never, 2 = Once in my life, 3 = Once a year, 4 = Once every 6 months, 5 = Once a month, 6 = Once a week, 7 = Once every 2 or 3 days, and 8 = At least once every day). Respondents are instructed to provide answers based on their experiences between ages six and 18 years. This age restriction was based on the assumption that participants’ memory for events prior to age six would be less reliable. The subscales are scored by calculating the mean of all items of that subscale, with subscale scores ranging from 1 to 8, based on the response options given above (Table 1).

Table 1: Distribution of Study 1 and Study 2 Participants’ Responses to Item of the APSQ

Following the development of the scale, Study 1 and Study 2 were carried out to establish the validity of the APSQ and to examine the relationship of scores on the questionnaire to wellbeing. The aims of these studies were (a) to provide psychometric evidence that the Abuse and Encouragement subscales are distinct and reliable, (b) to show convergent and divergent construct validity with subscales of another parenting style questionnaire (PAQ), (c) to show divergent construct validity with a measure of personality, (d) to examine the relationship between of the APSQ and well-being, (e) to examine whether the two subscales of the APSQ (Abuse and Encouragement) contributed independently to well-being, and (f) to provide preliminary data as to whether abusive parenting has a linear or nonlinear relationship to well-being. An additional aim was to document the frequency of parenting behaviors such as beating. Results from Study 1 and Study 2 are presented together to facilitate comparison of the two samples.

Ethical approval for this study was obtained from the University of Plymouth’s Human Ethics Committee. Prior to participating in either of the two studies, all participants were given written information about the studies and gave written consent to participate. All participants were given written debriefing information after questionnaire completion.

Study 1

Methods

For Study 1, potential participants were approach at work (at a Saudi petroleum company) and asked to complete the APSQ in addition to three other questionnaires: The Parental Authority Questionnaire (PAQ), the Big Five Inventory (BFI), and the Global Quality of Life Scale (GQOL). The PAQ (Buri, 1991) is a 30- item questionnaire with three, 10-item subscales: authoritarian, authoritative, permissive parenting style. The scale has been previously translated into Arabic and used in Saudi Arabia (Dwairy et al., 2006). In order to reduce participant burden in the current study, the scale was shorted by selecting the five items that load most strongly on each of the three subscales; these items were considered most representative of and central to each subscale.

The BFI (Benet-Martinez & John, 1998) is a well-known inventory measuring five dimensions of personality: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. A shortened version of the BFI consists of 21 items (Rammstedt & John, 2005). An Arabic translation of the shorter questionnaire was previously developed for use in Saudi Arabia (Al Tamimi, 2009) and was adopted for the present study. The Arabic version includes 20 items, because the one item relating to artistic skills was dropped; the item was deemed largely irrelevant in Saudi society because acting and playing music are uncommon in Saudi Arabia.

The GQOL is a single-item, 100-point scale used to measure quality of life (Hyland & Sodergren, 1996). With the original authors’ permission, the scale was translated into Arabic for the present study.

To validate retrospective recall of events, participants also completed a version of the APSQ in which they were asked to rate the items not on the basis of experiences when they were between the ages of six and 18, but 18 years or older. This form of the APSQ is referred to as the Adult version of the APSQ.

Participants

Study 1 included 249 students (149 male, 100 female) aged 19 to 25 years (M = 20.80 years, SD = 1.85) who were attending a petroleum company training program in Saudi Arabia. Potential participants were excluded only if they reported that either parent died when the participant was a child between ages six and 18.

Study 2

Methods

For Study 2, potential participants were approached through educational meetings organized by a Saudi charity in Saudi Arabia. In addition to the APSQ, individuals who consented to take part in the study were given three other questionnaires: the GQOL (discussed above), the Satisfaction With Life Scale (SWLS), and a measure of positive and negative affect.

The Satisfaction With Life Scale (SWLS; Pavot & Diener, 1993) is a five-item scale to assess respondents’ satisfaction or contentment with their lives. An Arabic version of the scale was created for previous research (see Al Tamimi, 2009) and used in this study.

The Positive and Negative Affect Scale (PANAS) is a wellknown, 20-item scale used to measure positive and negative affect (Watson et al., 1988). An Arabic scale based on the PANAS was constructed with permission from the authors.

Participants in Study 2 also completed the Adult version of the APSQ in which they were instructed to rate each of the items on the basis of their experience after 18 years of age (i.e. not between ages 6 and 18 as in the instructions for the APSQ).

Participants

Study 2 included 293 Saudi citizens (185 male, 108 female) aged 19 to 49 years (M = 27.20 years, SD = 7.27) who were recruited through meetings organized by Social Developmental Committee (CSDC) in Saudi Arabia. As for Study 1, potential participants were excluded only if they reported that either parent died when the participant was a child between ages six and 18.

Results

Many of the data collected and analyses performed in Studies 1 and 2 are parallel, and thus they are presented together in this section to facilitate comparison. Responses for each item of the APSQ for both Study 1 and Study 2 are shown in Table 1. There were no significant differences between males and females for either the Abuse or the Encouragement subscales of the APSQ for either study. Both samples show considerable variation in reported level of Abuse and Encouragement.

Only participants in Study 2 had ranged enough in age for correlational analysis to be performed. Among participants in Study 2, age was negatively correlated with Abuse, r(291) = -0.17, p <0.01, and with Encouragement, r(291) = -0.18, p <0.01, showing a weak tendency for older participants to report less abuse and to be more likely to report being encouraged during childhood.

Exploratory Factor Analysis (EFA, using principal axis extraction, two-factor extraction, varimax rotation) of the questionnaire responses from participants in Study 1 and in Study 2 indicated a clear separation of the seven items into two distinct, interpretable, and replicable factors: Abuse and Encouragement. Items and their associated loadings are shown in Table 2. The reliability of the Abuse subscale, assessed by Cronbach’s alpha, was 0.86 (Study 1) and 0.75 (Study 2); the reliability of the Encouragement subscale was 0.76 (Study 1) and 0.78 (Study 2).

Table 2: Factor Loadings from Exploratory Factor Analyses of the APSQ

The Abuse subscale correlated with the Encouragement subscale at r(247) = -0.21, p < 0.001 for Sample 1 and r(291) = -0.19, p < 0.001 for Sample 2, indicating a weak association between Abuse and Encouragement. For Study 2, the relationships between participants’ responses to the questionnaire pertaining to their experiences between ages six and 18 with their responses to the questionnaire pertaining to their experiences after age 18 (the adult form) were also examined. The correlations of each of the subscales with the corresponding subscale of the adult APSQ were r(291) = 0.59, p < 0.001, for the Abuse subscale, and r(291) = 0.76, p < 0.001, for the Encouragement subscale. These correlations show considerable convergence between the adult and child experience. Table 3 shows the correlation coefficients between all variables in Study 1 with the exception of the BFI. There is one moderate correlation between the two parenting style questionnaires, namely between the Encouragement subscale of the new questionnaire and authoritative parenting as assessed on the PAQ. However, aside from that correlation, the two parenting style questionnaires appear to be measuring different constructs. Both subscales of APSQ and two subscales of the PAQ are significantly correlated with overall life satisfaction. To examine the extent to which the APSQ and PAQ provide independent predictions of overall quality of life, multiple regression was used to predict results on the GQOL (the dependent variable) based on the subscales of the parenting questionnaires that significantly correlated with GQOL scores (Table 3). Beta and significance values are as follows: Abuse: beta = -0.26, p <0.001; Encouragement: beta = 0.01, p = 0.807; Authoritative: beta = 0.29, p <0.001; and Authoritarian: beta = -0.12, p = 0.049. These results show that the Abuse (APSQ), Authoritative (PAQ), and Authoritarian (PAQ) subscales all contribute independent variance to quality of life.

Table 3: Study 1: Correlations between the Arabic Parenting Style Questionnaire (APSQ) and Global Quality of Life Scale (GQOL), N = 249

The correlations of the subscales of the APSQ with the five personality factors (Study 1) are shown in Table 4. The correlation coefficients are relatively weak, evidence supporting the discriminant validity of the scales, or the notion that the APSQ and the BFI measure unique variables.

Table 4: Study 1: Correlations between the APSQ and BFI traits, N = 249

The correlations of the APSQ subscales and all other measures used in Study 2 are presented in Table 5. There is a weak, positive relationship between Negative Affect and Abuse, indicating that individuals who score higher on the Abuse subscale also report more negative affect. There is also a weak, positive relationship between Positive Affect and Encouragement, indicating that individuals who score higher on the Encouragement subscale also report more positive affect. Both subscales of the APSQ correlate with life satisfaction (assessed using the SWLS) and overall quality of life (assessed using the GQOL). In order to test the independent effects of Abuse and Encouragement on quality of life, life satisfaction, and positive and negative affect, separate multiple regression models were used to predict each of these variables with Abuse and Encouragement entered as the dependent variables. The results are shown in Table 6. Abuse and Encouragement independently predicted SWLS and GQOL, but only Abuse predicted Negative Affect and only Encouragement predicted Positive Affect.

Table 5: Study 2: Correlations between all variables, N = 293

Table 6: Study 2: Multiple Regression using APSQ Abuse and Encouragement as Predictors

In order to examine the relationship between Abusive parenting and well-being at differing levels of abuse, the Abuse subscale was divided into quartiles, or four ranges of scores. The mean score and confidence intervals for participants falling in each of these four ranges of scores for GQOL and SWLS are shown in Tables 7 and 8. The patterns of results are not identical between Study 1 and Study 2, but taken together the results of the two studies indicate that there is a decrease in well-being across the full range of abusive parenting style, from mild to severe abusive parenting.

Table 7: Mean score for GQOL at Four Levels of Abusive Parenting (APSQ) for Studies 1 and 2

Table 8: Mean score for SWLS at Four Levels of Abusive parenting (APSQ) for Study 2, N = 293

Discussion

Study 1 and Study 2 documented the level of reported abusive and encouraging parenting behaviors in Saudi Arabia. The frequency of beating varied considerably across participants. Approximately 56% to 67% of participants reported that they were beaten never or only once in their lives, whereas approximately 6% to 8% reported that there were beaten at least once a week. In contrast, verbal abuse was more common with 30% to 40% of participants reporting that they were never insulted or insulted at most once in their lives by their parents, whereas 11% to 12% reported that they were insulted at least once a week.

The study has big sample number and a small percentage of respondents is still a representative. Furthermore, when adding all the periods (once a month, once every 6 months….etc.) it adds up in my view. The fact that the correlation shows a sig effect (abuse on wellbeing….etc.) is an indication that the abuse as a variable, nevertheless, is influential factor in this study.

The divergence between abuse and encouragement is also an indication of the singularity of this factor in the study. The present data shows some relationship between abuse and other variables (e.g., wellbeing), it is a step forward to understand such relationship. It is hoped that further research will shed more light on the abuse factor and its relation to well-being in later life in a Saudi sample.

Similar variability was found for participants’ reports of receiving encouragement from their parents. Approximately 20% to 37% said they had been encouraged to speak frankly when expressing their own opinions at most once in their lives. Younger respondents reported slightly more encouragement but also more abuse.

These results indicate considerable heterogeneity in parenting style in Saudi Arabia, consistent with a society in transition and exhibiting the variation between traditional and modern cultural practices. Dwairy (2006) suggests that authoritarian parenting of girls is stricter than of boys in Arab/Muslim cultures. However, in the present study no differences were found between men’s and women’s retrospective reports of their parents’ abusive and encouraging parenting practices. During questionnaire construction, about one-fifth of both men and women indicated that their parents kept something (e.g., a stick) with which to beat them. These results indicate similarity between parenting of boys and girls, as well as variation in practice between families.

A second aim of the two studies was to establish the validity of the two subscales of the APSQ. Factor analysis supported the existence of two separate and interpretable factors, Abuse and Encouragement, with high factor loadings of items on their respective factors, and no evidence of cross-loading. Despite having only a small number of items, the two subscales had acceptable levels of internal consistency. These two subscales were weakly and negatively correlated (r of approximately -0.20), indicating that abusive treatment is associated with less encouragement.

The relationship between the Abuse and Encouragement subscales of the APSQ and the subscales of the PAQ were also examined. Encouragement was correlated (r = 0.43) with Authoritative parenting style. This comparatively high correlation is to be expected as some Authoritative parenting items contain the word “encouragement” and there is conceptual overlap between encouraging children and providing a rationale-based form of authority. Data collected using the PAQ are consistent with results from studies previously conducted in Arab countries, showing a correlation of 0.36 between Authoritative parenting and overall quality of life (on the GQOL) and a correlation of -0.16 between Authoritarian parenting and overall quality of life (see Dwairy et al., 2006, for discussion). These results corroborate early research suggesting that the effect of authoritarian parenting is less harmful in Arab countries than in the West – in both the present research and that reported by Dwairy et al. (2006) the correlations with authoritarian parenting were significant but with small effect sizes.

There were small but significant correlations (r = 0.15 to 0.26) between the Abuse subscale of the APSQ and each of the three subscales of the PAQ, showing that abusive parenting is weakly and negatively related to Authoritative and Permissive parenting and positively related to Authoritarian parenting. Thus, there is a relationship between the PAQ and APSQ, but there is considerable difference between abuse and authoritarianism because authoritarian child-rearing does not necessarily include physical punishment or yelling at the child.

Multiple regression showed that the PAQ and APSQ predicted independent variance in GQOL. These results show that although the PAQ and APSQ are related questionnaires, they measure separate constructs and provide independent prediction of quality of life.

Neither of the subscales of the APSQ were strongly correlated with measures of personality as measured by the BFI, providing evidence of divergent validity. These results suggest that abusive and encouraging parenting styles have little effect on personality – possibly because personality is determined in part by genetics (Heath, Cloninger, & Martin, 1994). There was, however, a weak relationship (r = 0.19) between Encouragement and Conscientiousness. Although this correlation does not include any evidence of causality, the relationship between these two factors does call into question whether parenting style might impact conscientiousness in developing children.

Recollections of childhood parenting style with participants’ descriptions of their relationships with their parents in adult life were also compared. Participants’ responses to the APSQ based on their childhood (age 6 to 18 years) experiences and responses to a separate version based on their adult (age 18 years and older) experiences were found to be strongly and positively correlated. This finding was consistent with other research (de Rivera, 1997) showing the validity of the method of retrospective recall, and the finding also indicates that the relationship between parents and children in Arab countries remains fixed even after the child becomes an adult.

Both the Abuse and Encouragement subscales of the APSQ predict well-being, which was operationalized using three measures: satisfaction with life (SWLS), global quality of life (GQOL), and affect (assessed with a scale based on the PANAS). Abuse and Encouragement predicted all three measures of well-being. As there was a weak negative correlation between Abuse and Encouragement, Study 2 was designed to investigate to what extent they contributed independent variance to well-being. Results from a multiple regression analysis indicate that Abuse and Encouragement independently predict separate variance in participants’ responses to the SWLS and GQOL, explaining 14% and 11% of the variance respectively. However, only the Abuse subscale was a significant predictor of Negative Affect, and only the Encouragement subscale was a significant predictor of Positive Affect.

The finding that Abuse is linked to Negative Affect and Encouragement to Positive Affect is consistent with predictions from infornet theory. According to this theory, the whole body (not only the brain) is a network system (a psychoneuroimmunoendocrine network) that operates according to connectionist principles. Punishments that signal that the world is an unsafe place lead – through the application of network learning rules – to gradual and persistent changes in the network. One result or consequence is negative affect. In contrast, repeated information that there are novel and rewarding opportunities in the environment leads to a gradual and persistent change, one consequence of which is positive affect. These results are consistent with theoretical predictions that abuse and encouragement during childhood involve different mechanisms in terms of their effects on well-being in adult life.

To the best of our knowledge, this is the first study to examine the effects of abusive parenting on well-being in a country where harsh discipline is a culturally accepted form of child-rearing. The results are no different from those found in the West – abusive parenting has negative consequences for well-being. A scale measuring the degree of abusive parenting was used, and so we were able to examine the consequences of abusive parenting over the full range of parental behavior, not just in the case of extreme abuse. Preliminary data suggest that the negative effects of abusive parenting occur not only at the extreme end (i.e., what would undoubtedly be termed abuse); negative effects are also found, to a lesser degree, in association with parenting styles that tend towards abusiveness. In Tables 7 and 8, the lowest category of abuse (1–2) comprises those who reported being beaten or insulted at most once in their lives, and the second lowest category of abuse (>2–3) still experienced relatively low rates of abuse (Table 1 for illustration). Most of the sample falls in these two groups. The conclusion that low levels of abuse have a detectable effect on quality of life and life satisfaction should be seen as preliminary because the majority of participants reported low levels of abusive parenting. Comparison across levels of abuse would be improved by having a larger sample reporting higher levels of abuse. Furthermore, the relationship between abuse and outcome shown in Table 8 do not partial out effects due to other variables. Nevertheless, these data do suggest the possibility that that even moderately low levels of abuse have negative consequences, a possibility consistent with the theoretical prediction that abusive experiences have a cumulative effect (Hyland, 2011).

Acknowledgements

Faculty of Medicine, AlBaha University, Saudi Arabia

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