Parenting styles, adolescent nutrition and mental-health 1

Parenting Styles, Feeding Practices and Adolescent

Mental-Health: an exploratory study

Amruta Ashok Shaligram

Department of Psychology

SMT. M.M.P Shah Women‟s College of Arts & Commerce

Affiliated to S.N.D.T Women‟s University

 Parenting styles, adolescent nutrition and mental-health 2

INDEX

Abstract

1. Introduction

2. Literature Review

3. Methods

3.1. Hypothesis of the proposed research.

3.2. Participants.

3.3. Research Design.

3.3.1. Operational Definition of variables.

3.4. Tools.

3.5. Procedure.

3.5.1. Ethical Considerations.

3.6. Data Analysis.

3.7. Limitations

References

Appendices:

Appendix 1: Parenting Styles and Dimensions Questionnaire (PSDQ).

Appendix 2: Adolescent Food Habits Checklist (AFHC).

Appendix 3: Child Behaviour Checklist (CBCL).

 Parenting styles, adolescent nutrition and mental-health 3

ABSTRACT

Promoting mental health is essential during period of adolescent because it is a critical time
for the physical and psychological growth of a person. A successful physical and mental
development during adolescence is depended on many factors, one such factor receiving a
considerable amount of attention is nutritional intake. However, a growing body of evidence
suggest that there is deterioration seen in the quality of food consumed by this age group over
past decades. This decline in diet quality has led to an apparent parallel increase in adolescent
mental health problems. Evidence suggests the importance of the social environment for
influencing dietary behaviour. One such type of environmental influences that has received
increasing research attention in recent years is the influence that parents can have on
children‟s dietary behaviour through food related practices. Given (a) there is a relationship
between diet quality and mental health in adolescent and , (b) consumption of food could be
influenced by parenting styles and feeding practices, the purpose of this exploratory study is
to examine the relationship between parenting styles, with their adopted feeding practices and
eating behaviours and mental health in adolescent. Parenting Styles would be measured by
Parenting Styles and Dimensions Questionnaire (PSDQ) (Robinson et al., 1995). The feeding
practices adopted by the parents or caregivers would be measured using The Child Feeding
Questionnaire (CFQ) (Birch et al., 2001). The eating behaviours of adolescent would be
measured by Adolescent Food Habit Checklist (Johnson et al., 2002) and the mental health of
the adolescent would be measured using the Child Behaviour Checklist for Ages 4 – 18
(CBCL/4 – 18) (Achenbach, 1991).Regression analysis would be conducted to examine the
relationship between parenting styles, feeding styles and adolescent mental – health and
eating behaviours. Further a MANCOVA would be performed in order to examine
differences in adolescent mental-health and eating behaviour that exists between families
following (a) authoritarian parenting style, (b) permissive parenting style and (c) authoritative
parenting style.

Keywords: Parental Styles, Feeding Practices, Internalizing Behaviour, Adolescent.

 Parenting styles, adolescent nutrition and mental-health 4

Chapter 1

INTRODUCTION

It is estimated that, each year 20% of adolescents suffer from a mental health disorder
(UNICEF, 2012). According to Belfer (2008), 50% of all adult mental health problems had
their onsets during adolescence. The most prevalent mental-health disorder is Unipolar
Depression and is the primary contributor to disability in this age group (Coffey et al., 2009).
Evidence has proved a significant deterioration in physical and emotional health of
adolescents due to depression (Meredith et al., 2009; Thapar et al., 2012). Therefore
investigating the factors influencing the psychological well-being of young people is a high a
high priority. One such factor is the „type of food‟ consumed by adolescents. Evidence
demonstrates that there is gradual declines in the quality of diet young people have in recent
times (Adair and Popkin, 2005; Nielsen and Popkin, 2003; Nielsen et al., 1996; Wang et al.,
2008). Over a past decade, several researches have focused on the role of habitual diet in the
development of internalizing behaviours which represent low mood, depressive symptoms or
anxiety (Mykletun et al., 2010; Akbaraly and Brunner, 2010; Alonso et al., 2009). Results‟
demonstrating an inverse relationship between the quality of food and role of depression in
adolescence has led to an interest in the possible role of nutrition in the development and
progression of depressive symptoms. A study by Jacka et al., (2011) highlights the
importance of diet in adolescence and its potential role in modifying mental-health over the
life course. Eating habits of an adolescent may be influenced by several potential factors; the
one being rigorously researched is the role of social environment on dietary behaviour. One
of the most influential components of the adolescent‟s immediate environment is the family.
A type of family influence that has received increasing research attention in recent years is
the influence that parents may have on their children‟s dietary behaviour through food –
related parenting practices (Birch, 1998; Birch and Fisher, 2000; Carper, Fisher and Birch,
2000). Parenting involves a great responsibility in limiting and promoting behaviours in
children, especially eating behaviours.
Decades of research have been dedicated to developing a framework for parenting styles.
Diana Baumrind‟s (1971) authoritative, authoritarian and permissive typologies are currently
widely employed models of parenting styles. Baumrind‟s work and an extensive large body
of research have established strong associations between each parenting style and a particular
set of child behaviours. Stemming from the earlier work of Schaefer (1959, 1965), a
 Parenting styles, adolescent nutrition and mental-health 5

circumplex model describing the overall pattern of parent behaviour, Baumrind (1966, 1968)
conceptualized three parenting prototypes to explain patterns of parental control and child
socialization. They are, (a) authoritative parents – high on acceptance and behavioural
control, but low on psychological control, (b) authoritarian parents – rejecting and
psychologically controlling and (c) permissive – accepting and exhibiting lax behavioural
control (Baumrind et al; 2010; Baumrind, 2013). Baumrind (1966) conceptualized
authoritative parents as rational, warm, encouraging and controlling in a way that promotes
child autonomy. Authoritative parents value a child‟s individuality but also stress social
constraints. In accordance with this, Maccoby and Martin (1983), state that authoritative
parent are clear in setting rules and often use reasoning to enforce them. They believe in
encouraging open communication, supporting children‟s independence and expressing love
and affection. The literature on various parenting styles provide evidence that parental
warmth, emotional support, appropriate granting of autonomy and clear, bidirectional
communication lead to positive developmental outcomes in children and adolescent
(Maccoby and Martin, 1983). These constellations of characteristics are found in
authoritative parenting styles, also identified to be an optimal parenting style. According to
Baumrind (1966), authoritarian parents value control and unquestioning obedience.
Authoritarian parents are highly demanding and are often punitive and forceful in order to
adhere to an absolute standard of behaviour (Baumrind, 1966). This parenting style has been
related to less optimal child outcomes, including lower self-esteem and self-efficacy
(Baumrind et al., 2010). They have also been related to increased rebelliousness (Baumrind,
1968) and externalizing problems (Maccoby and Martin, 1983). Permissive parents value
self-expression and self-regulation (Baumrind, 1966). Parents included in this type are
affirming and place few behavioural demands on the child. These parents avoid coercive or
confrontive practices as much as possible (Baumrind, 1989). Maccoby and Martin (1983),
have conceptualized permissive parents as indulgent and allowing children to make their own
rules and decisions. Adolescents having such parents have lower achievements (Baumrind,
1971), lack impulse control (Maccoby and Marin, 1983) and have lower autonomy
(Baumrind et al., 2010).
Based on Baumrind‟s (1973) taxonomy, Birch and Fisher (1995) identified three child-
feeding patterns. Authoritarian feeding is characterized by attempts to control the child‟s
eating with little regard for the child‟s choices and preferences. Authoritative feeding
encourages a child to eat healthy foods, but the child is also given autonomy for eating
 Parenting styles, adolescent nutrition and mental-health 6

options. Permissive feeding is whereby the child is allowed to eat whatever he or she wants in
whatever quantities he or she wants. The model given by Birch and Fisher (1995) helps us to
understand along with different parenting styles, parents even follow a distinct feeding style
which may have a direct or an indirect influence over a child‟s concept of healthy or
unhealthy eating. As research suggests lack of inadequate nutrition-dense food may be one of
the important casual factors in the development of psychological problems like anxiety,
depression and other internalizing behaviours. Although one set of empirical studies points
out the importance of parenting feeding styles and its crucial role in inducing a healthy eating
behaviour in a child (S.P.J. Kremers et al., 2003; H. Patrick et al., 2005; Patrick, Theresa and
Nicklas, 2005) and second set of studies have established a positive association between
healthy eating habits and psychological well-being in adolescent ( W.H.Oddy et al., 2009;
Jacka et al., 2011; O‟ Niel et al., 2011; A. A. Kulkarni et al., 2015) there is a lack of a
comprehensive study wherein the effects of all these variables are examined together.
Especially in country like India, where child autonomy is not given importance, parenting
styles would have a larger impact in shaping adolescents eating behaviour and its subsequent
effects on their mental-health. The aim of the present study is to explore the role of parenting
styles and their adopted feeding practices as an environmental context factors in influencing
and promoting healthy eating behaviour and positive psychological health amongst Indian
adolescents.
 Parenting styles, adolescent nutrition and mental-health 7

Chapter 2

REVIEW OF LITERATURE

(a) Role of Healthy Diet in Internalizing Behaviour in Adolescent

Dietary patterns or habits can be categorized as healthy or prudent dietary patterns which
are characterized by a higher intake of nutrient-dense food and unhealthy patterns are
characterized by regular intake of food with high saturated fat, refined carbohydrates and
processed food products (O‟Neil et al., 2014). Higher intake of nutrition dense foods
leads to a successful development of physical and mental wellbeing during adolescent
whereas there are evidence demonstrating a fall in the diet quality of young people in
recent decades (Adair and Popkin, 2005; Nielsen and Popkin, 2003; Wang and Zhai,
2008). In recent times there has been seen a subsequent decrease in the quality of food
and increase in the quantity of food consumed by adolescent throughout the globe.
Much of the researches have had their focus on the effect of unhealthy dietary habits on
externalizing behaviour, such as hyperactivity (Weghuber and Zwaan, 2012). However,
little attention has been given to the relationship between dietary intake and internalizing
behaviour which represent low mood, depressive symptoms or anxiety in adolescents and
children. A study conducted by Oddy et al., (2009), indicated that adolescents eating
more Western-style diet were more vulnerable to develop both internalizing and
externalizing behavioural problems as compared to their peers who consumed a more
nutrition dense foods. These findings are found to be consistent with previous cross
sectional studies done on dietary patterns and mental health in adolescents. A study
conducted by Jacka et al., (2011), found that there was association between diet quality
and mental health symptoms in a large sample of Australian adolescents. Other
significant findings proposed by this study were, changes in diet quality were directly
associated with changes in the mental health, improvements in the dietary patterns were
positively correlated with higher scores on psychological health. Likewise a study
conducted by Weng et al ., (2012) on Chinese adolescent reported that diets which were
high in unhealthy foods and low in fruits and vegetables were associated with increased
likelihood of negative behavioural issues. A study on the sample of ethnically diverse
adolescents from East London confirmed that unhealthy dietary habits were associated
 Parenting styles, adolescent nutrition and mental-health 8

with mental health problems (Jacka et al., 2013). The above mentioned studies does
demonstrate that a decline in consumption nutrition-dense food have its adverse effects
not only on the physical well-being of the person but also on the psychological well-
being. Although the evidence is insufficient in establishing a direct relationship between
food habits and mental health, there are several potential explanations which exist for the
relationship between diet and mental health in this population. Firstly, it may be the case
that adolescent suffering from anxiety or depressive symptoms may tend to eat more
sugary or fried foods as form of self-medication or as a method to reduce anxiety caused
by external factors. Secondly, there might have been a lack of proper nutritional intake in
their developing years. Thirdly, there might be a significant impact of family and social
environment on dietary behaviour of these adolescents. Looking at these various
explanations, the last one is the area which has failed to receive quite a lot focus other
than its role in treating children with obesity. But research evidence also suggests that
adolescents and children suffering from obesity have some mental health issue.
Therefore it is of a significant importance to shed light on understanding parenting styles
and its relative importance in promoting healthy eating behaviour and its subsequent
effect on the child‟s mental health. One of the objectives of the proposed study is to
determine whether food habits, specifically those taught by the parents of an adolescent
have any effects on his/her mental – health. Currently the three parenting styles are of
particular interest in research examining many parenting domain, one of them being
feeding related parenting and feeding styles and practices.

(b) Feeding Styles

In order to prevent overweight or negative physical consequences, parents may adopt
controlling feeding practices for the child (Birch and Davison, 2001; Casey and Rozin,
1989). Therefore as per the prescribed dietary guideline of healthy and unhealthy foods,
parents may attempt to put restrictions on child‟s intake of „bad‟ food and encourage
increasing the intake of „good‟ food. Based on Baumrind‟s model of „parenting styles‟ of
authoritarian, permissive and authoritative, Birch and Fisher (1995) have come with a
model of „feeding styles‟ representing the caregivers approach to maintain or modify
children‟s behaviour with respect to eating. Authoritarian feeding style represents
behaviours such as restricting child from eating certain foods preferably junk-food and
forcing the child to eat healthy foods like fruits and vegetables. Therefore this feeding
 Parenting styles, adolescent nutrition and mental-health 9

style is characterized by absolute control of the parent over the child‟s food intake with
little or less regard to his likes or dislikes. Permissive feeding style is characterized by a
parent having no control over the child‟s food intake. This may be called as „nutritional
neglect‟ (Birch and Fisher, 1995), wherein the child is allowed to have whatever he likes
and can have in as much quantity as he likes. The last one is authoritative feeding styles
represented by a balance between the first two feeding styles, wherein a child may be
encouraged to eat healthy foods but also given some choices of his own eating options.
Feeding styles have been associated with dietary intake of a child (Patrick et al., 2005).
Authoritarian feeding has been associated with lower intake of fruits, juices and
vegetables, in contrast to this authoritative feeding has been associated with increased
intake of fruits and vegetables and decreased intake of junk food (Cullen et al., 2000;
Gable and Lutz, 2000). In a study done by Patrick et al., (2005), authoritative feeding was
positively associated with the child consumption of dairy, fruits and vegetables, suggesting
that with regards to feeding authoritative parents seem to promote more healthful eating
pattern in children. In the same study it was also found that authoritarian feeding was
negatively associated with the child consumption of vegetables, suggesting that
authoritarian feeding seems to promote less healthful eating patterns in children.
Adolescents who reported more permissiveness in their family ate more fat and sweet
foods, snacks and reported less healthy food choices in the family (De Bourdeaudhuij,
1997; De Bourdeaudhuij and Van Oost, 1996). Research evidence suggests that increased
intake of snack, fast food, sweet and fried foods and decreased intake of fruits and
vegetables may have a substantial immediate effect on the mental-health and well-being of
adolescents (Adair and Popkin, 2005; Nielsen and Popkin, 2003; Wang and Zhai, 2008).
Therefore one of the key aims of this proposed study is to illustrate the effects that feeding
styles may have on the psychological health of adolescents.

(c ) Feeding Practices
In recent times, a type of family or style of parenting particularly influence that parents
may have on their children‟s dietary behaviour through food related parenting practices
has received considerable amount of research attention (Birch, 1998; Birch and Fisher,
2000; Carper, Fisher and Birch, 2000). Parental feeding practices are specific strategies
used by parents, which can directly or indirectly influence children‟s eating patterns and
weight status (Blissett, 2011). Birch (2001), identified three feeding practices through
 Parenting styles, adolescent nutrition and mental-health 10

which parents attempt to have a control over child‟s eating behaviour: restriction,
pressure to eat and monitoring. Restriction refers to parental attempts to limit unhealthy
foods, but an inverse effect is seen wherein there is an increase in the consumption of
those foods (Birch et al., 2001). Similar to this pressure to eat refers to parental attempts
to get children to eat more healthy foods, but this has led to a decrease in consumption of
these foods (Birch et al., 2001). As opposed to the first two practices, the feeding
practice of monitoring the amount and type of food a child eats has been regarded as a
more positive way to control what children eat (Hubbs – Tait, Kennedy, Page, Topham
and Harrist, 2008). Parent‟s attempts to put restrictions on some foods and encourage
others have been associated with preferences children have for certain kinds of food.
Looking at the model given by Birch and Fisher (1995), it is demonstrated that dietary
habits may be influenced by parental styles of upbringing and disciplinary methods. It
may be safe to say that the population that could be best related to this model may be of
early childhood because these children have yet to develop their autonomy and parents
and family environment may still be an immediate influential component in this age
group. But adolescent stage, along with family environment, is also influenced by school,
friends and social environment. Similarly eating habits may also undergo a huge shift
once the child moves out of protected environment, therefore in situations like these how
much control can a parent have over the adolescent‟s food habits is an area waiting to be
explored. Evaluating the „feeding styles‟ there can be various assumptions drawn, for
instance adolescent having parents following authoritative feeding style may tend to have
more balanced healthy foods which decreases his vulnerability towards developing
internalizing behaviours. Secondly, adolescent having parents following permissive
feeding style may always tends to have sugary, fried foods which may increase his
chances of developing anxiety or depressive symptoms. Therefore it is necessary to
create awareness within the parent population regarding educating and having some
amount of control over the adolescent‟s dietary pattern because having a balanced
nutritional diet promotes his overall psychological well-being in addition to continued
implications to future quality of life.
 Parenting styles, adolescent nutrition and mental-health 11

Chapter 3

METHODOLOGY

3.1. Hypotheses for the proposed research study

 Hypothesis no. 1:- „There is a relationship between parenting styles, eating behaviour
and internalizing behaviours in adolescent‟.
 Hypothesis no. 2:- „There is a relationship between healthy eating behaviour and
internalizing behaviours in adolescents‟.
 Hypothesis no. 3:- „There is relationship between parental feeding practices and
eating behaviour and internalizing behaviours in adolescents‟.
 Hypothesis no. 4:- „There is a difference between parenting styles and its effects on
eating behaviours and internalizing behaviours in adolescents‟.
 Hypothesis no. 5:- „There is a difference between parenting feeding practices and its
effects on eating behaviours and internalizing behaviours in adolescents‟

3.2. Participants
The target population for the proposed study will be 100 Indian adolescents of age group
of 10 – 12 years of age and their parents both mother and father. The data would be
collected from various schools established in the city of Thane, Maharashtra. The
adolescent population will be of mix gender. A general questionnaire will be
administered as a screening technique to, first exclude adolescents with single or
divorced parents, second to determine the basic understanding and use of English
language within the targeted population as the questionnaires administered would be in
English.
 Parenting styles, adolescent nutrition and mental-health 12

3.3. Research Design

The adopted research design is a multifactorial design having 2 independent variables:

1.Parenting Styles and 2. Feeding Practices, with each having 3 levels: 1. Parenting
Styles – (a) authoritarian, (b) authoritative, (c) permissive; 2. Feeding Practices – (a)
restriction, (b) pressure to eat, (c) monitoring and 2 dependent variables: 1. Eating
Behaviour and 2. Internalizing Behaviour. It would be a quantitative research performing
an exploratory study, exploring (a) association between parenting styles, eating
behaviour and internalizing behaviours of adolescents, (b) association between parenting
feeding practices, eating behaviour and internalizing behaviours in adolescents.

3.3.1. Operational definitions of variables

 Independent Variables

(1). Parenting Styles operationally defined as parent‟s attitudes and values about
parenting, their beliefs about nature of children and adopted practices employed by
them for upbringing and socialization of their children (Baumrind, 1966). Measured
by Parenting Styles and Dimensions Questionnaire (PSDQ) (Robinson et al., 1995),
the parenting styles are further classifies into 3 distinct categories:- (a) Authoritative
Parenting Style – Parenting Style characterized by rational, warm, encouraging and
controlling disciplinary methods promoting child autonomy (Baumrind, 1966), (b)
Authoritarian Parenting Style – Parenting Style characterized by high on
demandingness, punitive and forceful disciplinary methods to adhere to an absolute
standard for behaviour (Baumrind, 1966), (c) Permissive Parenting Style – Parenting
Style characterized by acceptance and exhibiting lax behavioural control and also
placing few behavioural demands on the child, promoting psychological autonomy
(Baumrind, 1966; Baumrind et al., 2010; Baumrind, 2013).

(2). Feeding Practices operationally defined as parent practices and perceptions

regarding child feeding (Birch et al., 2001). Measured by Child Feeding
Questionnaire (CFQ) (Birch et al., 2001), the feeding practices are divided into 3
types :-( a) Restriction – Method for parental attempt to limit unhealthy foods (Birch
et al., 2001), (b) Pressure to eat – Method for parental attempt to get children to eat
 Parenting styles, adolescent nutrition and mental-health 13

more healthy foods (Birch et al., 2010), (c) Monitoring – Method for parental
attempt to monitor the amount and type of food a child eats (Birch et al., 2010).

 Dependent Variables

(1). Eating Behaviour operationally defined as adolescents healthy eating habits.

(2). Adolescent Mental-Health operationally defined as Internalizing behaviours

(withdrawal, somatic complaints, anxious/depressed) as measured by Child Health
Behaviour Checklist (CBCL/4-18) (Achenbach, 2001).

 Control Variables

Factors like age, school vicinity and family constellations of the participating
population will be the control variables for the proposed research study.

3.4. Tools

1. Parenting Styles & Dimensions Questionnaire (PSDQ) (Robinson et al., 1995) – It is a

self-report instrument designed to measure authoritarian, authoritative, and permissive
parenting styles of 4-12 years old children‟s parents. This scale was developed by
Robinson, Mandelco, Olsen and Hart in 1995. The tool was designed around
Baumrind‟s (1966, 1991) three main typologies (authoritative, authoritarian, and
permissive) but there is no specific classification scheme avalaible to determine a
predominant style (Jhonson, 2010). The scale includes 62 items (Robinson, Mandelco,
Olsen and Hart, 1995). Each item of the scale is evaluated with the five points likert
described as, “never”, “once in a while”, “about a half of the time”, “always”. Internal
reliability for PSDQ tested with the technique of Cronbach Alpha was .63 (Robinson
et al., 1995). Robinson et al., (1995) reported the reliabilities of the 3 dimensions of
PSQD as follows: Authoritative (Cronbach alpha of .91), Authoritarian (Cronbach
alpha of .86) and Permissive (Cronbach alpha of .75). PSDQ also has a high test –
retest reliability.

2. The Child Feeding Questionnaire (CFQ) (Birch et al., 2001) – This questionnaire is
used to examine parent practices and perceptions regarding child feeding practices.
 Parenting styles, adolescent nutrition and mental-health 14

There are 3 sub – scales in CFQ measuring restriction, pressure and monitoring (Birch
et al., 2001). Item response for CFQ is done by using five – point Likert – type scales
ranging from “never” to “always” or “agree” to “disagree”. Validity for CFQ has been
previously established by conducting confirmatory factor analysis in samples
comprised of parents of 5 – to – 9 – years – olds and parents of 8 – to – 11 – years –
olds from diverse backgrounds (Birch et al., 2001). Internal consistency reliabilities of
the sub – scales were reported as .73 for restriction, .70 for pressure and .92 for
monitoring by Birch et al., (2001).

3. Adolescent Food Habit Checklist (AFHC) (Johnson et al., 2002) – This checklist
provides a measure of adolescent healthy eating behaviour with reference to those
situations in which young children are likely to have a degree of personal control.
AFHC contains 23 items having true/false response format (Johnson et al, 2002).
Amongst 23 items, 10 items have a response equivalent to „not – applicable‟.
Participants receive 1 point for each „healthy response‟. The final score is adjusted for
„not – applicable‟ and missing responses using the formula: AFHC score = number of
„healthy responses‟ × (23/number of items completed) (Johnson et al., 2002). The test
– retest reliability of the 23 items of AFHC was .90 and internal reliability was
(Cronbach‟s alpha of .82) (Johnson et al., 2002).

4. Child Behaviour Checklist for Ages 4 – 18 (CBCL/4-18) (Achenbach, 1991) –

Indicators of adolescent mental health will be measured using Child Behaviour
Checklist for Ages 4 – 18 (CBCL/4 – 18 , a 118 – item empirically validated measure
and effective screening tool for child mental health problems which is completed by
the adolescent‟s primary caregiver (Warnick et al., 2008). The CBCL is used to
measure behaviour as a continuous score, in addition to appropriating factors into
clinical syndrome scales including withdrawal, somatic complaints,
anxious/depressed, social, attention, thought, aggression and delinquency scales
(Achenbach, 1991). A T-score for overall behaviour was produced (Mean (M) =
46.53, Standard Deviation (SD) = 11.67) .For the sub-scale of Internalizing
behaviours (withdrawal, somatic complaints, anxious/depressed) calculated Mean was
(M) = 46.62 and Standard Deviation (SD) = 10.80) (Achenbach, 1991).
 Parenting styles, adolescent nutrition and mental-health 15

3.5. Procedure

Parents of the targeted age – group of adolescents will be approached during Parents-
Teachers Conferences of selected schools in the city of Thane, Maharashtra. The aims,
objectives and applications of the proposed study will be explained to them and consent
forms will be distributed for the parents who are willing to participate in the study. A
separate set of consent form will be given to the children of the interested parents as well
as school Principle and the school authorities. The questionnaires of PSDQ, CFQ and
CBCL will be administered to the participating parents and relevant data will be
collected. Similarly, the AFHC will be administered to the participating adolescent
population and relevant data will be collected.

3.5.1 Ethical Considerations

Before distributing the consent forms, measures will be taken to provide

appropriate and honest information regarding the aims and objectives of the study.
The consent forms will be personally signed by the participating families,
Principle‟s of participating schools and school authorities. The obtained data will
be kept confidential. Steps will be taken to ensure that after the conduction of the
study, the obtained results would not be published without the consent of the
school authorities and the participants.

3.6 Data Analysis

(a) Regression Analysis

Two separate sets of Multiple Regression Analysis will be performed:-

 First- exploring the association between Parenting styles specified as first

independent variables having 3 levels and Eating Behaviour and Internalizing
Behaviours in adolescents specified as dependent variables.
 Parenting styles, adolescent nutrition and mental-health 16

 Second- exploring the association between Feeding Practices specified as

second independent variables having 3 levels and Eating Behaviours and
Internalizing Behaviours specified as dependent variables.

(b) Multivariate Analysis of Co-variants (MANCOVA)

A MANCOVA will be performed in order to examine the difference in adolescents

eating behaviour and Internalizing Behaviour that exists between family units
adopting (a) Authoritative, (b) Authoritarian, (c) Permissive parenting styles and (a)
Restriction, (b) Pressure to eat, (c) Monitoring feeding practices.

3.7 Limitations

There may be several limitations to the proposed study. The first being Gender will not
be considered as one of the controls or variables to minimize the statistical analysis
procedure. However, research could be done as adopting Gender Differences as one of
the variables. Secondly, socio-economic status of the participating parents will not be
determined to test whether the effects of „parenting styles and feeding practices‟ on
adolescent eating behaviours and their mental health are generalizable and applicable
across all sections of population irrespective of their socioeconomic status.
 Parenting styles, adolescent nutrition and mental-health 17

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