Psychological factors contributing to parenting styles: A systematic review [version 1; peer review: 1 approved with reservations, 1 not approved]

1Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran 2Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran 3Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran 4Sexual and Reproductive Health Research Center, Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran


Introduction
Parenting styles refer to the set of strategies adopted by parents to control the behaviors of their children 1 . It has two models: positive parenting styles, i.e. authoritative parenting style; and negative parenting styles that are authoritarian, permissive, and neglectful 2,3 . In this respect, positive parenting styles are accompanied by encouraging outcomes for children such as optimism, self-esteem, and social-emotional development [4][5][6] , while negative parenting can lead to emotional disorders, behavioral problems 7 , aggression 8 , as well as child anxiety 9 . Although, previous review studies have investigated different factors contributing to raising children and child maltreatment, including socio economic factors 8,10 , and parent and child characteristics 8,11-16 , less is known about psychological factors that contribute to parenting style. The objective of this systematic review was to conduct a comprehensive literature review on the psychological factors affecting parenting styles.

Methods
In this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used as a guideline 17 . See Supplementary File 1 for the PRISMA checklist.

Identification of the research question
Considering the "P" component of PICO (Population of interest, intervention, control, outcome) criteria and FINER (Feasibility, Interesting, Novel, Ethical, Relevant) criteria, the research question was developed as below: 18,19 .
What are the psychological factors contributing to parenting styles?

Search strategy
According to the research question in this study, a search was carried out in the databases of Google Scholar, PubMed, Scopus, Web of Science, and Scientific Information Database (a Persian database). In this regard, the required articles were retrieved based on the use of medical subject headings, text words, and related keywords. The search strategy was as follows: ("Psychosocial Factors" OR Factors OR Determination OR Psychology) AND ("Child Rearing OR Child Rearing Styles" OR Parenting OR "Parent-Child Relations OR Parent-Child Relationship" OR "Parenting Styles").

Eligibility criteria.
All indexed and non-indexed original cross-sectional, longitudinal or review studies, in English or Persian, that meet the inclusion criteria, addressed the research question, reported parenting styles in at least one of the parents were retrieved, irrespective of the types of parenting style, recruitment method and instruments used for the assessment of parenting style. Studies that reported on the results of clinical trials were excluded from our review. 416 articles published within February 1984 and April 2017 were extracted. The search time lasted for four weeks between January 23rd and February 23rd in 2018.

Study selection.
After removing duplicate articles (191), those remaining were examined in two stages. Firstly, the titles and a summary of all the remaining articles were independently reviewed by two authors (ZS and ZV). At this stage, 120 articles were excluded from the study.
Secondly, the full texts of all the remaining articles were examined and the items not referring to psychological factors in spite of attention to the factors related to parenting styles were excluded. Additionally, the reference lists of the selected articles were reviewed for more articles. Finally, 48 articles were used. Figure 1 illustrates the study flow.
Summarization, extraction, and data reporting Two authors (ZH and ZV) independently extracted basic study information (author's name, title and year of publication, sample characteristics, type of study and outcomes such as: parenting styles, parent's behavior, parent child interaction, family interaction) for all included papers using a predefined evidence table shell. Third author (FE) reviewed the evidence tables for accuracy and completeness. The final evidence table is presented in Table 1. After selecting the final articles, the researchers carefully examined all the relevant articles, extracted the data, and then organized the information needed for the present study. The results of the literature review led to categorization of the contents on psychological factors contributing to parenting styles into several categories as presented in the Results section.

Risk of bias
Critical appraisal checklists were used to evaluate the quality of the studies. Checklists were adapted from the Newcastle-Ottawa quality assessment scale 20 to assess three broad perspective of each study: the selection of the study groups, the comparability of the groups, and the ascertainment of either the exposure for case-control studies or the outcome of interest for cohort studies and cross-sectional studies. This checklist includes 8 questions for case control studies and cohort studies with maximum 9 score. For cross-sectional studies, this checklist includes 6 questions with maximum 7 score. Ottawa quality assessment scale has established content validity and inter-rater reliability 21,22 . We used The HE QAT to assess the methodological quality of all included reviews as well. The HE QAT assesses 10 criteria to measure the extent to which the methodological approach of a review guarded against bias with maximum 10 score 23 . In this review, studies that received ≥ 5 score from Newcastle-Ottawa scale and The HE QAT were included 20,23 .

Ethical considerations
The authors assumed ethical considerations and general standards of publication including avoidance of plagiarism as well as multiple and simultaneous submissions and respect for the intellectual property rights of studies.

Results
The quality assessment of all studies presented in Table 1 is included in Supplementary File 2. The review of the literature led to the categorization of psychological factors affecting parenting styles as factors related to parents and those to children. Psychological characteristics relating to parents Mental health status. Parents' mental health status is often directly correlated with parenting styles. As can be seen, parents affected with psychological distress may treat their own children with hostility and rejection. Such parents may adopt harsh disciplinary rules and probably make use of physical punishment 10,24 . In this regard, it has been shown that a history of major depressive disorders is inversely correlated with authoritative parenting styles and it is positively correlated with authoritarian parenting style 24 . Moreover, depressed parents do not show proper sentiments or emotions towards their children or their feelings about parenting responsibilities are assumed negative 25 . These parents may have low self-esteem, reduced self-efficacy, negative emotions, more anger and distress, as well as negative worthlessness to themselves or negative attitudes towards their parenting abilities 11,26,27 , which have an impact on the trust between parents and children 12,28,29 . On the other hand, mothers suffering from bipolar disorder are likely to Children's perceptions of inter parental conflict, of parent-child relations, and measures of child adjustment were examined in to explore the role of parent and child gender in these associations. Marital conflict negatively impacted perceptions of father-child relationships after controlling for the effect of marital conflict on mother-child relationships. Perceptions of inter parental conflict were more strongly associated with negative motherson relationships compared to same-gender dyads. adopt an avoidant and insecure attachment style towards their children and show more anger in their interactions with family members 13 . Anxiety can be also a stressor with undesirable effects on a healthy coping system and parents' compliance problems and finally create negative parenting. Such parents may use harassment of their children as a first choice of parenting 12 , or parents' interactions with children and their parenting may be accompanied by excessive control and rejection 30,31 .
One of the serious problems in the domain of parents' mental health affecting parenting can be schizophrenia. In this regard, it has been shown that children that have schizophrenic parents grow up with many environmental stressors, such as parental dysfunction. Schizophrenia also has a significant effect on the ability to maintain a close and reciprocal relationship and this issue has an impact on parenting capacity. It has been observed that mothers of schizophrenic women are more remote, insensitive and it is likely to be correlated with less parenting skills 32 . In addition, such parents may be less involved with their children and they cannot create a positive emotional atmosphere for them 13 .

Self-efficacy.
Parents with higher self-efficacy are endowed with more self-confidence in order to achieve effective parenting skills and competence and they are also likely to have more success with positive parenting. Parental self-efficacy may affect parenting satisfaction and such an impact on coping ability can be positive. These parents may proactively make efforts in problematic situations, such as lack of social support or presence of economic problems, to reduce the negative effects of these problems on their children. In contrast, parents with lower levels of self-efficacy may not be able to adopt positive parenting strategies 26 .
Parenting stress. One of the factors associated with parents' characteristics is parenting stress. Parenting stress arises when parenting demands exceed the actual resources available to parents that permit them to succeed in parenting. Accordingly, parents with higher parenting stress are more rejectionists and less protective 33 . Greater parenting stress tends to use more punishment and less affection toward children 34 . Stresses affecting parenting also include child-rearing stress as well as a sense of being restrained due to the presence of children 35 . It has been also observed that parents with parenting stress adopt authoritarian parenting styles 34 . Parenting stress can similarly give parents anxiety and emotional distress and cause irritability and hostile behaviors by creating negative feelings. These parents may easily react with psychological aggression and physical punishment in the case of misbehavior by children 34 .
Perfectionism. Perfectionism is a parental characteristic and also a personality trait. Accordingly, perfectionist parents try to be perfect and unflawed. They are extremely critical of themselves and their behaviors. These parents similarly consider wishes and goals they could not reach for themselves for their own children and apply their own standards to them 36 . Moreover, these parents may show their love to their children when children act in accordance with parents expectations. In order to maintain their self-esteem, they also put more pressure on their children to avoid failures, characterizing authoritarian parenting styles. Furthermore, perfectionist parents have high expectations of their children and these parental characteristics can result in authoritative parenting styles if they are responsive to their children 37 .
Personality traits. Parental personality traits are among the most important factors influencing parenting styles 38,39 . According to the existing literature, the personality traits of extraversion, conscientiousness, agreeableness, and openness to experience can be accompanied by greater intimacy in parenting styles 8,39,40 and a neurotic personality trait can be seen in less intimate parents. Giving a smaller amount of autonomy to children is also related to authoritarian parenting styles 8,41,42 . Parents with agreeable personality traits, due to their ability to obtain more social support and avoid social conflicts, generally are less likely to develop depression 43,44 . Agreeable parents also try to have flexible and child-centered parenting. Parents who are open to new experiences have emotionally stable personality traits and enjoy new experiences using their imagination and participate in a wide range of mental and experiential endeavors; therefore, this personality trait may be associated with positive parenting since having a child is a new experience 44 . As well, parents who are conscientiousness are disciplined and they are individuals with good parenting roles. Their children also accept them as an appropriate model 45 . Moreover, extraverted individuals have positive emotional states and feel good about themselves and the world; and ultimately neuroticpsychotic parents have much more adverse and negative emotions 44,46 .
Childhood trauma. The history of physical, sexual, or emotional abuse among parents in their childhood is considered as a risk factor leading to negative parenting styles 27,47 .
In this respect, perceived childhood maltreatment towards parents can have an effect on creating interpersonal problems including interactions with their own children. It is also a risk factor for subsequent emotional defects, which can result in a series of interpersonal difficulties such as distrust, uncertainty, and avoidance of intimate relationships. Also, there is a relationship between physical and emotional abuse in childhood and adverse outcomes for parents such as less parenting competence, more parenting stress, reduced use of effective parenting styles, parental hostility, use of physical punishment, and neglect towards children. In other words, a history of maltreatment can create a lasting environment during the development of children that can last until adulthood. Moreover, it has been observed that mothers with sexual abuse history in childhood may suffer from greater parenting stress, which can lead to diminished empathy with their own children 27,48 .

Marital satisfaction.
Among the parental characteristics contributing to parenting styles is marital satisfaction 49 . In this respect, parents with satisfactory marital relationships may have positive behaviors with their children. Conversely, when parents are dissatisfied with marital relationships, negative emotions and behaviors can be transferred through parent-child interactions 24 . Marital conflict as a stressor can affect couples and increase their anger. Consequently, this anger can spread to children and decrease affection towards them 15,50 . It has been argued that marital maladjustment can lead to an increase in instability in socio-emotional domains in families resulting in ineffective and inconsistent parenting practices by parents 51 .
Parents' attachment style. Parental characteristics including their attachment style and family conditions in the past such as stress or supportive relationships in their immediate family can determine their parenting styles 52,53 . People with secure attachment styles towards their own parents consider their relationships, whether positive or negative, clear, consistent and coherent. These parents have more intimate parenting style and they are responsive to their children 53 . However, parents with insecure or anxious attachment in their childhood can have pervasive anger as well as lower intimacy and participation in their current relationships with their children 53,54 . These problems can have long-term consequences in mental health and interpersonal relationships in terms of parenting 12 or some parents showing more anger towards their own parents may make special efforts to create positive relationships with their own children 53 .
Perceived parenting style. Individuals that have loving and responsive childhood with no severe restrictions on them are endowed with healthy socio-emotional development; they also have high self-esteem and internalized control 55 . As the result of emotional security, behavioral independence and social competence created in them can lead to the formation of a healthy personality and personal maturity and these people can rely more on others. Eventually, these individuals have active interactions as well as more intimacy and acceptance towards their children in the future and ultimately adopt a positive parenting style 8 . In contrast, there are parents with harsh parenting during their own childhood who may treat their children strictly and believe in using more physical punishment for their children as their parents believed 56,57 .
Substance abuse. Substance abuse is considered as a factor affecting parenting 14 . Substance abuse is also recognized as a risk factor for maltreatment of children and may cause the use of violence 47 . Marital problems as well as psychological disorders of substance-abusing individuals are related to poor parenting 14 .
Psychological factors relating to children Developmental and mental disabilities. Illnesses and disabilities of children can cause emotional distress in parents, which may lead to psychopathology, such as more anxiety, in both parents. This mental disorder can also result in negative and inappropriate parenting styles 58 . For example, children with disabilities such as Down's syndrome may have more behavioral problems than children without this disability, and their parents overprotect them which can lead to improper parenting. On the other hand, the siblings of these children may be cared for and controlled less than children that have no disability 59 .When parents cannot deal with emotional difficulties and control child temperament because of too much stress, they cannot have positive parenting styles, especially the ability to respond appropriately using a suitable approach towards their children 58 .
Although it is demonstrated that if parents perceive the cause of their children's difficult emotional temperaments, it is possible that earning necessary skills to address these problems can reduce stress in parents and create a more positive parenting style 58 .
Child temperament. Child temperament such as negative emotions, maladjustment, and anger can make it difficult to care for children. It can also undermine parents' performance particularly in childhood and their behavior may become more hostile lacking love and affection 26,60 . Parents of children with a difficult temperament also have higher parenting stress and psychological problems, such as feeling negative about their parenting. Some characteristics seen in children, such as hyperactivity and inability to establish suitable social relationships, are similarly considered among their temperament characteristics and can have an adverse effect on parent-child relationships 61 .
In addition, shyness is among the characteristics associated with child temperament. Thus, children with behavioral inhibition and social fearfulness are restrained and their tolerance threshold is different 62 . Thus, parents show more intimate behaviors towards children who have more social interactions and they are more likely to adopt much more authoritative parenting styles 31 . Finally, parents with children with higher emotional intelligence can establish a better relationship with them and they may also adopt positive parenting styles 63 .
Anxiety. Anxiety disorder in children may lead to the adoption of a negative parenting style, such as more control. For example, a study revealed that parenting was significantly correlated with children's anxiety disorder. Such a disorder, regardless of the level of anxiety in parents, is associated with a less intimate relationship with children. Moreover, children's anxiety also causes mothers to have overprotection for their own children 16,30 . As well, parents having children affected with anxiety disorder may give them less independence and show not as much of acceptance and love to them 14 .

Discussion
This systematic review was an attempt to examine a range of psychological factors related to parenting styles to offer a useful collection that considers parent-child characteristics. The results of this study showed that studies that identify effective psychological factors for parenting styles were related. Consequently, increased self-efficacy and reduced parenting stress as well as lower depression and anxiety in parents could lead to the adoption of more appropriate strategies 12,24,26,34 . Moreover, dimensions of perfectionism in parents and parental personality traits could effect parenting styles 37,39,40 . The range of parents' psychological disturbances such as depression and anxiety could also affect parental dysfunction, leading to child maltreatment; and consequently parents' psychopathology could increase the likelihood of inappropriate and ineffective parenting 14,24 .
Parenting is also influenced by the characteristics of parents' personality traits 40 . These characteristics are created in the process of parents' growth and development 8 . Therefore, parents with greater agreeableness, extraversion, who are conscientiousness and open to new experiences, with lower neuroticism, are more intimate, organized, and stable and they are also more responsive to their children 40,41 .
The history of parental evolution and the way parents have interacted with their own parents can also influence how they behave with their children in the future 56 . If parents have been mentally disturbed in these previous relationships, their parenting ability can be adversely affected 27,48 . Parents experiencing love in their childhood and having a secure attachment to their parents can show more positive parenting in adulthood for their children, while insecure attachments may be a risk factor for future parenting and reduce their positive parenting capacities 53,54 . Studies have also shown how childhood trauma as well as physical, sexual, and emotional abuse during childhood can shape parenting styles in the future. The experience of these injuries can similarly lead to emotional and social impairment and disturb parent-child interactions, and consequently make parents adopt negative parenting styles 27,48 .
The results of this study indicated that parents having satisfactory and supportive marital relationships were more sensitive and responsive to their child's needs 34,49 . In addition, psychological factors such as depression and parenting stress can affect other types of family relationships, such as marital and parent-child relationships 24,34,35 . Moreover, substance abuse was recognized as a risk factor for exercising violence against children 47 .
In general, the findings suggested that children's psychological characteristics such as developmental and mental disabilities, temperament, social fearfulness and shyness, attachment, anxiety, and emotional intelligence should be considered in determining the factors contributing to parenting styles. These factors may also bring about psychological problems in parents such as negative feelings about parenting or even lead to challenging behaviors in children or mental health problems in children or parents, which in turn can have an effect on parenting styles 30,59,63 .
In conclusion, considering these multiple psychological factors influencing parenting styles, we recommended including parent-child psychological status assessment in family health programs in order to identify the needs for health-oriented care and take steps towards the development of parenting skills among parents.

Limitations
Although this study examined the psychological factors contributing to parenting styles, the impact of couples' psychological characteristics on each other's parenting styles was not elucidated. Therefore, future research can shed light on the psychological characteristics of couples interacting with each other as well as the effects on their parenting styles. Despite these limitations it seems the result of this study can be used in the development and implementation of family health intervention programs. Also clinicians, psychologists, psychiatrists, and counselors may consider the psychological factors affecting parenting styles reported in this review for further interventions; the assessment of parent-child mental health status, as well as positive parenting education and in this way help with positive parent-child interactions.

Data availability
All data underlying the results are available as part of the article and no additional source data are required.

Competing interests
No competing interests were disclosed.

Grant information
Student Research Committee of Mazandaran University of Medical Sciences for their financial support of this project (code number, 2952).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Supplementary File 2: Quality assessment of all articles.
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other logics. The writing and grammar should be improved, and the manuscript is limited by the lack of clarity in the writing.
characteristics and other issues. Maybe the category of "Psychological factors relating to children" is not needed.