Introduction
Child anxiety can be a problem if it is excessive and interferes with the child’s daily life [
1]. Lifetime anxiety disorders often start in childhood with the first peak of the onset of anxiety disorders at 5.5 years [
2]. Anxiety disorders in childhood may become chronic and can impact a wide range of factors relevant to quality of life, including eating disorders, physical health, poor education, poor employment, etc. [
3]. Therefore, early assessment of potential risk factors for the development of anxiety disorders is essential to prevent lifetime anxiety problems.
A number of factors have been demonstrated to increase risk for the development and maintenance of child anxiety disorders, including genetic and temperamental vulnerability, social and environmental factors, and internal, psychological factors (e.g., [
4‐
6]). Among the social and environmental factors of relevance to childhood anxiety disorders, a range of parental behaviours have been implicated [
6‐
8]. Foremost among these is parent overprotection, which has been found to be associated with anxiety disorders in children and adolescents [
9,
10]. Parent overprotection is defined as parents’ excessively cautious behaviour toward their children due to concern for their children’s safety or health [
11]. Parent
overprotection is sometimes used interchangeably with parent
overcontrol and
overinvolvement, but it is a different construct.
Overcontrol is where parents help or interfere with children’s behaviour without considering children’s desires or interests, and
overinvolvement is a broader involvement construct consisting of parents’ overprotection and overcontrol [
11,
12]. It is hypothesised that parent overprotection may limit a child’s opportunity to face feared situations, learn from their experience, and develop self-efficacy [
13]. It has also been hypothesised that parental overprotection may be a response to child anxiety (e.g., [
14]) highlighting the importance of reliable measures that can be used to test directional hypotheses.
Several scales have been developed to measure parent overprotection however many existing measures have limitations due to poor internal consistency, a restricted item pool and reliance on child reports. Two of the most commonly used measures are the Egna Minnen Beträffande Uppfostran scale (EMBU) and the Parental Bonding Instrument (PBI). The child-reported EMBU-C consists of 4 factors, emotional warmth, overprotection, favouring subject, and parental rejection [
15]. The overprotection factor of the EMBU-C, based on child reports of both mother and father behaviours, has been found to be positively correlated with child trait anxiety [
16]. However, the overprotection factor has modest internal consistency (Cronbach’s α = 0.65–0.67 [
15],). The brief current form of the Parental Bonding Instrument (PBI-BC [
17],) also includes a control/autonomy factor which indicates parents’ tendency to overprotection. Child ratings of both mother and father control/autonomy have been found to significantly correlate with child social anxiety [
17]. However the control/autonomy factor only includes two items that assess overprotection (i.e. ‘My mother tries to control everything I do’,’My mother treats me like a baby and tries to protect me from everything’) and these items do not address specific overprotective behaviours. Furthermore it is unclear to what extent anxiety influences children’s perceptions of and reports of parental overprotection which introduces challenges with interpretation of findings.
Although some scales measure parents’ perspectives of overprotective behaviour, these scales have mostly been designed to measure parent overprotection in relation to children/adolescents over 7 years old and not in relation to younger children. For example, a parent-reported version of the EMBU (EMBU-P) was validated with parents of undergraduate students (mean age of 20.33 years; [
18]) and a later study implemented the EMBU-P with parents of children from 7 to 18 years old who had been diagnosed with obsessive–compulsive disorder [
19]. This study showed that the EMBU-P consists of the same 4 factors as the EMBU-C with good internal consistency, but the study did not examine its validity. Measures of parents’ perception of overprotective behaviour toward young children remain limited despite their potential utility for early detection of risk factors for anxiety disorders.
There are several scales to measure parents’ perspectives of overprotection toward young children, such as Overinvolved/Protective Parenting Scale, New Friends Vignettes, Attitudes about Parenting Strategies for Anxiety, etc. [
20]. One scale that has been widely used in clinical studies to measure parents’ views of their behaviour toward their preschool-aged children is the Parent Overprotection Measure (POM [
21,
22],). The POM has been found to have high internal consistency, test–retest reliability, and construct validity, and significantly correlates with child anxiety symptoms but not most externalising symptoms [
23]. POM scores measured when children were aged 3–5 years were also longitudinally associated with child anxiety symptoms a year later [
24]. However, another study conducted with parents of older children (7 to 12 years) only found a significant association between POM and maternal anxiety symptoms and not child anxiety symptoms [
21], suggesting that parental overprotection, as measured by the POM, may principally be associated with anxiety in preschool-aged children. Taken together, POM is a promising scale to assess parent overprotection toward preschool-aged children. However, previous studies have only evaluated the POM total score, and the factor structure has not been examined to confirm whether the POM is measuring a unitary construct of overprotection or consists of several underlying dimensions which might function differently from each other.
Previous research has highlighted that some parental behaviours are interpreted differently in different cultures so it is important that measures are evaluated in distinct cultural contexts. Notably, the overprotection factor in the Japanese translation of the EMBU-C loaded on both control and care dimensions, whereas the overprotection factor in the English EMBU-C showed high loading only on control dimensions [
25,
26]. Also, Japanese parents may typically be more heavily involved in aspects of their children’s behaviour than Western parents. For example, previous research has indicated that American mothers tend to interpret children’s demanding behaviours as attention-seeking, while Japanese mothers interpret them as a need for security and interdependence [
27]. This different interpretation may cause parents to respond in different ways to their children’s behaviour, with Japanese parents potentially more likely to respond to children’s demanding behaviour with protective behaviours. These cultural differences indicate that parenting measures collected in Japan might have different psychometric properties to English-language parenting measures used in Western countries.
The purpose of this study was to translate the English version of the POM into Japanese and examine its factor structure, reliability, and validity based on both mother and father reports. First, we randomly split the total sample of children into two groups and conducted an exploratory factor analysis (EFA) of the Japanese translation of POM (in random group 1), followed by a confirmatory factor analysis (CFA) to confirm the factor structure (in random group 2). Second, to assess psychometric equivalence across mother and father reports, we examined measurement invariance of the mother and father reported Japanese POM. Since traditional gender roles might influence the association between parent overprotection and offspring anxiety [
28], we examined the reliability and validity of mother and father reports separately. Third, we calculated the reliability of the mother and father reported Japanese translation of the POM separately by estimating McDonald’s ω coefficients. Fourth, we examined the association between the mother and father reported Japanese translation of the POM and child/parent anxiety symptoms, which is related construct to parent overprotection. We hypothesised that the POM would be weakly correlated with both child and parent anxiety symptoms (
r ≥ 0.20), referring to the correlation coefficient between the mother/father reported POM and child/parent anxiety symptoms in previous studies [
21,
23]. Last, we hypothesised that the correlation between the POM and externalising symptoms (hyperactivity-inattention and conduct problems) would be weak (
r ≤ 0.10), indicating discriminant validity of the Japanese translation of the POM. The cut-off point was set at 0.10 based on the correlation coefficient between the mother/father reported POM and externalising symptoms in a previous study [
23].
Discussion
The purpose of the study was to evaluate the factor structure, reliability, and validity of the mother and father reports of a Japanese translation of the Parent Overprotection Measure (POM). We examined the factor structure of the POM using both exploratory and confirmatory perspectives. The Japanese translation of the POM yielded a bi-factor structure, with the general factor explaining most variance in the data. The bi-factor model exceeded the acceptable level of CFI, RMSEA, and SRMR [
39,
40]. Measurement invariance between mother and father reports was supported.
Previous studies using the POM have utilised a total score in accordance with the assumption of unidimensionality (e.g., [
23]). This is the first study to empirically assess the factor structure of the POM, and the result was partially consistent with this assumption. However, not all the variance in the POM was explained by the general factor, and residual variances were explained by two specific factors, which we consider to reflect care/attention for specific factor 1 and control/prevention for specific factor 2. The nature of the specific factors was determined based on the characteristics of the items in each factor and the directions of correlations with measures of anxiety and externalising symptoms. Two possible explanations for structure of the POM found here are that (i) parent overprotection is a parental behaviour that overlaps with the parent’s control and care behaviours. Previous studies often use overprotection and overcontrol interchangeably, and overprotection is highly associated with parental warmth, which may indicate some overprotective behaviours also function as control and care behaviours [
15,
45],and (ii) the Japanese translation of the POM may indicate a culture-specific structure. A previous Japanese study that found the overprotection factor in the EMBU-C loaded on higher factors of control and care dimensions [
26], whereas the EMBU-C only loaded on the control dimension among a Dutch sample [
25] highlighting the potential for cross-cultural differences. A future study is warranted to examine the factorial invariance or variance of the Japanese and English versions of the POM in different cultures. Having said this, although the general factor explained most of the variance in the POM, and the care/attention and control/prevention factors only explained 14.8–19.4% and 8.4–9.6% of the variance, respectively, the McDonald’s omega of the general overprotection, care/attention, and control/prevention factors of the POM were over 0.70, indicating sufficient reliability [
46]. Since general overprotection, care/attention, and control/prevention have sufficient reliability and relate differently to other measures, it may be beneficial to consider each factor separately to understand the parent’s characteristics from a broad perspective.
Our hypothesis that the POM would be correlated with both child and parent anxiety symptoms was not supported. The correlation between the general factor of the POM and child or parent anxiety symptoms did not exceed 0.20 for either mother or father reports. This result is inconsistent with previous studies which found correlations of greater than 0.20 between the POM and child and parent anxiety symptoms [
21,
23]. However, the correlation between the control/prevention factor and child anxiety was over 0.20 for both mother and father reports and the correlation between control/prevention factors and parent anxiety symptoms was over 0.20 for father reports. There are two possible explanations for the weak correlation for the general factor and moderate correlation for the control/prevention factor. One is that, given the best-fit model of the POM was the bi-factor model, all the variance in the POM might not be explained by one general factor. As found by Chevrier et al. [
47], different sorts of parent overprotection behaviours may be differentially associated with anxiety symptoms. Another possible reason is that the cultural norms and interpretation of parent overprotection may differ between cultures. Enmeshment between parent and child is valued and often interpreted as an expression of care in Asian cultures [
28,
48]. This may indicate that some of the general parent overprotection behaviours were interpreted as care and, as such, had less association with child and parent anxiety symptoms. Further studies are warranted to explore these possible reasons for its weak correlation with child and parent anxiety symptoms.
Our hypothesis that the correlation between the POM and externalising symptoms (hyperactivity-inattention and conduct problems) would be weak (
r ≤ 0.10) was supported. The correlation between the general factor and conduct problems and hyperactivity/inattention was less than 0.10, consistent with the previous findings [
23]. In contrast, conduct problems showed a significant and greater than 0.10 negative correlation with the care/attention factor for both the mother and father reports, and a significant and greater than 0.10 positive correlation with the control/prevention factor for father reports. This may suggest that the two specific factors may act slightly differently from overall parent overprotection. In line with our suggestion that among our Japanese population the subscales may reflect care/attention and control, a previous meta-analysis found that parental warmth is negatively associated with a child’s externalising problems, while parental psychological and harsh control is positively associated with a child’s externalising problems [
49].
Limitations
There were several limitations in this study. First, the assessment of validity relied completely on parent-reported measures of externalising symptoms. This study did not include another measure of parent overprotection, such as observational measures. In addition, the internal consistency of the subscales of the SDQ-P was low in this study. Second, test–retest reliability was not examined in the current study and this will be important to address in future studies. Third, this study purposefully included a Japanese sample however whether the factor structure can be generalised to other cultures is unclear. Given the current findings suggesting potential cross-cultural variation, it will be important to examine the factor structure and measurement invariance of the POM in other cultures in future studies. Finally, this study collected data from only one parent per child. It may be beneficial for future studies to collect both mother and father data for each child to compare parents’ overprotection of the same child, to help elucidate child versus parent effects.
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