Is War-Exposure Related to Parenting Behaviors? A Meta-Analysis on Harsh and Overprotective Parenting
Master Thesis
Graduate School of Child Development and Education Isabel Pahud de Mortanges
11131217
Supervised by: H. Eltanamly & Dr. P. H. O. Leijten Amsterdam, September 2017
Abstract
Many families are exposed to ongoing adverse life experiences caused by war related trauma. How war-exposure is related to parenting behaviors has received little attention. The experience of war can adversely affect parenting behaviors and might therefore increase harsh and overprotective parenting practices. The present meta-analysis examined whether war-exposure is related to harsher parenting and/or more overprotective parenting. We performed a random-effects model of the included studies covering the variation in the sizes of the true effect among studies. The outcome measure of the meta-analysis was the correlation between war-exposure and harsh and/or overprotective parenting. Nine electronic databases were searched to select the studies which were included in the meta-analysis. It was expected that war-exposure increased both types of parenting behaviors. Fourteen studies on war-exposed families and their relation to harsh parenting behaviors were included as well as one study regarding war-exposure and their relation to overprotective parenting. Our meta-analytic findings show that parents of families who are more severely exposed to war, seem to be harsher towards their children (r = .26, p < .001). Only one study reported on war-exposure and overprotective parenting, therefore effects cannot be meta-analyzed. The finding that war-exposure is related to harsher parenting, as well as the underrepresented research domain of overprotective parenting, is a cause for concern. Our findings state the importance of further research into how to help war-exposed families.
Is War-Exposure Related to Parenting Behaviors? A Meta-Analysis on Harsh and Overprotective Parenting
Many families are exposed to adverse life experiences caused by war related trauma every day (Lieberman, Chu, van Horn, & Harris, 2011). How war-exposure is related to parenting behaviors, has received little attention, despite its effects on millions of families across the globe (Halevi, Djalovski, Vengrober, & Feldman, 2016). Exposure to war includes various traumatic events such as bombings, air raids, physical injury, witnessing violence, loss of loved ones, displacement, disruption of life’s routine, lack of educational structure, living in poor conditions and with distressed parents (De Jong, 2002; Joshi & O’Donnell, 2003; Panter-Brick, Eggerman, Gonzalez, & Safdar, 2009). This study focusses on co-exposed families after the experience of war.
On the one hand children are a particularly vulnerable group who often suffer devastating long-term consequences if they experience or witness acts of war (Catani, Schauer, & Neuner, 2008). For example, being exposed to war can have negative long-term effects on aggressive and prosocial behavior of children (Kerestes, 2006). War-exposure may also have detrimental effects on children’s physical and mental health, negatively impacting their development as such (Yahav, 2014). This project is part of a broader review focusing on war-exposure and parenting practices and their relation to children’s mental health. That part of the study focusses explicitly on these issues.
On the other hand, the experience of war can affect parenting behaviors. Therefore, war can also affect children indirectly because it might change their parents’ parenting behaviors. When parenting behaviors are influenced, either in a positive or negative way, they might have a strong effect on a child’s development (Thabet, Tawahina, El Sarraj, & Vostanis, 2008). The way parents are affected by war may therefore be critical to how children respond to war-exposure (Lieberman & Knorr, 2007; Scheeringa & Zeanah, 2001; Qouta, Punamaki,
& El Sarraj, 2005). This is alarming since the quality of parenting after trauma-exposure may be profoundly influenced (Qouta et al., 2005). To illustrate, the experience of war might increase harsh parenting characterized by punishment, rejection, strictness and control (Punamaki, Qouta, & El Sarraj, 1997). It is also possible for parents who experience war to become more anxiously restrictive and overprotective in their parenting (Lieberman et al., 2011). Therefore, when parents endure war, it is possible they become less capable of using supportive parenting behaviors. My research focusses on the question whether exposure to war is related to harsh and/ or overprotective parenting.
Harsh Parenting and War-exposure
Harsh parenting includes coercive behaviors and negative emotional expressions, including verbal and physical aggression, that parents direct towards children (Hinnant, Erath, & El-Sheikh, 2015). Harsh parenting appears to be associated with higher levels of aggression (Gershoff, 2002), depression (McLeod, Weisz, & Wood, 2007) and social withdrawal (Booth-LaForce & Oxford, 2008) in children. It is therefore worrying that exposure to war might increase harsh parenting. There are several reasons why this might be the case.
First, war-exposure might increase the risk of harsh parenting due to parental distress (Miller & Jordans, 2016). Under stress, it may be more difficult for some parents to use warm and positive parenting behaviors. It appears that war-exposure specifically increases parents’ stress, which often leads to harsh parenting (Catani, 2010; Fowler, Cantos, & Miller, 2016). Therefore, parental stress has been suggested to influence the relation between war-related trauma exposure and children’s mental health (Qouta et al., 2005) through its impact on parenting behavior (Dyb, Jensen, & Nygaard, 2011; Schwerdtfeger & Geoff, 2007). Because of this, parental stress represents a significant risk to the healthy development of children and can heighten children’s adjustment difficulties (Khamis, 2016). Specifically, exposure to war
increased parental distress as well as their use of harsh parenting behaviors. It is therefore expected that the experience of war is related to harsher parenting strategies.
Second, war-exposure might also increase parental harshness trough parental mental health problems. It is likely that when parents suffer from mental health problems, because of war-exposure, they might become less capable of using positive and warm parenting
strategies (Barber, 1999). Parents seem to have an increased risk of developing depression-, anxiety- and Post Traumatic Stress Disorder (PTSD) symptoms (Ajdukovic & Ajdukovic, 1998; Lai, Hadi, & Llabre, 2014) after the experience of war. It appears that parents
psychological functioning and their mental health are established determinants of parenting behaviors (Field, 2010; Lovejoy, Graczyk, O’Hare, & Neuman, 2000). To illustrate, mothers who experienced traumatic events may become preoccupied with their own anxiety and behave in a harsh and frightening pattern, creating secondary traumatization for the child (Scheeringa & Zeanah, 2001). As a result, it is expected that exposure to war is related to harsher parenting.
However, research findings are inconsistent, suggesting there is no clear definitive answer as to whether war-exposure increases parental harshness or not. While some found a high correlation between war-exposure and harsh parenting (Sriskandarajah, Neuner, & Catani, 2015; Punamaki et al., 1997), others found a small correlation between war-exposure and harsh parenting (Bryce, Walker, Ghoraveb, & Kani, 1989; Garbarino & Kostelny, 1996). These inconsistencies in literature show the relevance for this meta-analysis to provide more insight into the actual strength of the relation between war-exposure and harsh parenting. Overprotective Parenting and War-Exposure
Overprotective parenting is characterized by intrusion, enmeshment, encouraging prolonged, and age-inappropriate dependence at the expense of individuation, separation, and autonomy. Overprotective parents tend to prevent children from exploring the world around
them (Bayer, Sanson, & Hemphill, 2006). Therefore, children can learn that problems are threatening and unresolvable and maintain the perception that situations are beyond their ability to cope (Wood, McLeod, Sigman, Hwang, & Chu, 2003). Children may then rely on avoidance, withdrawal and dependence upon caregivers as coping strategies (Gerull & Rapee, 2002). This can negatively influence child development (Bayer et al., 2006; Bayer, Sanson, & Hemphill, 2009). There are several reasons why war-exposure might increase overprotective parenting.
On the one hand, war-exposure might increase parental overprotection through children’s internalizing problems. It appears to be common for children to develop
internalizing problems after the experience of war (Lieberman et al., 2011; Rubin, Burgess, & Hastings, 2002). Overprotective parenting occurs frequently with children who are displaying internalizing problems (Rubin et al., 2002). Internalizing symptoms such as anxiety,
depression, withdrawal and separation anxiety in children have been associated with
overprotective parenting (Bayer et al., 2009; Bayer, Ukoumunne, Wake, Scalzo, & Nicholson, 2011; Edwards, Rapee, & Kennedy, 2010; Segrin, Wosizidlo, Givertz, Bauer, & Murphy 2012). Since children’s internalizing problems can lead to overprotective parenting, it might be likely that parents become more overprotective after the experience of war. It is therefore expected that the experience of war increases overprotective parenting.
On the other hand, war-exposure might also increase parental overprotection through parents’ own anxiety. Parents who are more anxious may be more likely to adopt an overprotective style of parenting because of their urge to protect children from external
threats (Lindhout et al., 2006). Since parents are profoundly more anxious after the experience of war (Lieberman et al., 2011) they might tend to use more overprotective parenting
strategies (Qouta et al., 2005). It is therefore expected that the experience of war increases overprotective parenting.
Co-existence of Harsh and Overprotective Parenting
Different parenting behaviors can co-exist (Macoby & Martin, 1983), as it is possible for parents to display a broad variety of different parenting behaviors (Belsky, 1984). Within the current study it is therefore thought that harsh and overprotective parenting can co-exist. To illustrate, parental control is an example of parenting behavior that is a sign of both harshness and overprotectiveness. Parental control can be classified as disciplinary and/or regulating (Barber, Stolz, & Olsen, 2005). Disciplinary parenting can correspond with harsh parenting and regulating parenting can correspond with overprotective parenting. Thus, controlling parenting is a sign of both harshness and overprotectiveness and it is thought that harsh and overprotective parenting can therefore co-exist.
The Present Study
While there have been numerous studies on the effect of war on parents’ and children’s mental health, little attention has been paid to war-exposed families and the specific parenting behaviors associated. Therefore, this study examines associations between the experience of war and harsh and/ or overprotective parenting. Since the literature on the relation between war-exposure and harsh parenting is inconsistent, a meta-analysis will be conducted aiming to establish if the exposure to war leads to harsher parenting. There are also reasons to suspect that war-exposure is related to more overprotective parenting. As to our knowledge, this is the first meta-analysis investigating the association between war-exposure and harsh and
or/overprotective parenting among war-affected families. This study is of vital importance to intervention workers, helping them to identify how best to help war-exposed families. Support to war-affected families is mostly focused on direct work with children. Little attention is being paid to parenting behaviors, as ongoing risk or protective factors in children’s lives. Thus, the findings of this study may have practical relevance for intervention workers.
The purpose of the meta-analysis is to answer the question: is there a relation between the experience of war and harsh and/or overprotective parenting? Specifically, it is
hypothesized that the experience of war increases harsh and overprotective parenting
behaviors. The study hypotheses are: (1) there is a positive association between war-exposure and harsh parenting and (2) there is a positive association between war-exposure and
overprotective parenting. This means that there may be an association between war-exposure as related to harsher and/or more overprotective parenting.
Method
This project is part of a broader review focusing on war-exposure and parenting practices and their relation to children’s mental health. This study, however, focused on associations between the experience of war and harsh and overprotective parenting. The collection of studies was performed by Eltanamly and two master students of the Graduate School of Child Development and Education.
Identification of Studies
A systematic review of published literature was performed to identify studies assessing war-exposure and harsh and/or overprotective parenting. Nine electronic databases were searched (e.g. PsycINFO, MEDLINE and Journal of Mental health). The following search terms were used in varying combinations: war, terrorism, political revolution or unrest, genocide, refugees, asylum seekers, parenting, childrearing.
Eligibility Criteria
A selection of the articles identified through the electronic database search for the entire project was made to select those studies eligible for inclusion in my study. Studies were included if they (1) reported on war-exposed families and harsh and/or overprotective parenting behaviors (2) comprised a population of both parents and children co-exposed to war, (3) were quantitative studies, (4) had groups larger than N = 5, (5) studied children in the
age range 0-18, (6) were published in peer-reviewed journals. Articles were excluded if they held no direct relevance to this study (e.g., titles unrelated to war-exposure, adolescents exposed to any intergenerational transmission of trauma, veteran studies, families not being co-exposed to war and publications not assessing harsh and overprotective parenting). Study Selection
First, the titles and abstracts were screened to identify studies for full text review according to the inclusion and exclusion criteria specified. Second, full-text copies of the remaining articles that appeared to meet criteria were reviewed. Inconsistencies related to the appropriateness of studies for inclusion were discussed in consultation with co-authors of the entire research project.
Data Extraction
Information was extracted from each of the included studies and contained a broad variety of topics (i.e., level of war-exposure, demographics, parenting behaviors and the effect of war on parenting behaviors). Studies were coded systematically by using a data extraction form for study and sample characteristics and outcome measures. To assess interrater
reliability, twenty percent of all included studies were blindly double coded by three trained researchers. Resulting in 5.4 % interrater difference, indicating a very good interrater reliability. Inconsistencies were solved in consultation with the other researchers. Data Analysis Strategy
This meta-analysis analyzed whether war-exposed parents showed harsher and/or more overprotective parenting. The outcome measure of the meta-analysis was the correlation between (1) war exposure and harsh parenting and (2) war exposure and overprotective parenting. Analyses were conducted in SPSS following the method of Lipsey and Wilson (2001) using Mean effect size (ES) macro’s. Each effect size was weighted by their inverse variance comparable to sample size. Data from the included studies were pooled by using a
random effects model. Random-effects models are most appropriate when a research domain is underrepresented (Overton, 1998). A random-effect model assumes there is variation in the size of the true effect among studies, resulting in heterogeneity (Hedges & Vevea, 1998). It was thought that the effect sizes from the included studies would differ according to the methodological quality of these studies (Anker, Reinhart, & Feeley, 2010). Therefore, a random effects model was used to analyze the data.
To assess whether the effect sizes are normally distributed, this was tested through a visual inspection of histograms, normal Q-Q plots and box plot. To test for homogeneity of effect sizes, the Q statistics was used (Hedges & Olkin, 1985). A significant Q statistic suggests that the distribution of effect sizes around the mean is greater than would be predicted from sampling error alone and therefore implies heterogeneity of effect sizes (Hedges & Olkin, 1985).
Risk of Bias Across Studies
Studies with minor effect sizes or studies with nonsignificant results are less likely to be published (Dwan et al., 2008) Publication bias is often referred to as the file drawer problem, where journals are filled with the 5% of studies that show Type I errors, while the 95% of the studies that show non-significant results are not mentioned (Rosenthal, 1979). Therefore, the possibility of publication bias has been assessed in two ways. A funnel plot was created and visually inspected for the data set. Secondly, a fail-safe N was calculated to check for publication bias.
Descriptive data
War-exposure. To illustrate the type of studies included in the meta-analysis in terms of war-exposure, we coded them in high, medium or low exposure. High exposure contained families who had to seek shelter within ten minutes, had a family member who was killed, lived under siege, saw a dead or mutilated body, witnessed shelling or gunfire and/or
witnessed killing. A medium exposure level contained families who lived in a refugee camp, knew of someone who got killed and were close to a combat situation. A low exposure level contained TV exposure to political violence.
Overprotective parenting. The type of studies included in the meta-analysis described overprotective parenting behaviors as intrusive and/or authoritarian.
Harsh parenting. The included studies in the meta-analysis described harsh parenting behaviors as corporal punishment, harsh discipline, psychological control, guilt induction, shaming and/or rejection.
Results Study Selection
Our search yielded 15 studies. Online database searches provided for 5148 citations. Following the removal of duplicates, the titles and abstracts of 3623 papers were screened to identify studies for full text review according to the specified inclusion and exclusion criteria. In this phase 83,4% of the papers were blindly double checked by at least two trained
researchers. Resulting in 12% interrater difference, indicating a good interrater reliability. In the next phase, full-text copies of the remaining 111 articles that appeared to meet criteria were reviewed. Figure 1 provides for a flow chart of study selection.
Study Characteristics
The included studies contained 14 studies regarding war-exposure and harsh parenting (k = 14) and one study (k = 1) regarding war-exposure and overprotective parenting. Most studies were conducted in Palestine (k = 6). Other studies were conducted in Sri Lanka (k = 2), Northern-Ireland (k = 2), Afghanistan (k = 2), Lebanon (k = 1), Uganda (k = 1) and Israel (k = 1). Children’s ages ranged from seven till eighteen years with a mean child age of (M = 12.84, SD = 2.21). The overall percentage of boys was 49.7% and the percentage of girls was 50.3%, showing that the children’s gender was almost equally divided. In total, eleven out of
the fifteen studies were published in 2007 or later. Hence, a lot of recent studies were used. Table 1 and 2 give an overview of all the studies in the present meta-analysis.
It was tested whether the data met the normality and homoscedasticity assumptions that apply to meta-analysis. The assumption of normality was not met in terms of the visual inspection. Although the Q-Q plots were all closely to the diagonal line and the box-plot did not show any outliers, the histogram showed a skewed distribution to the right indicating differences between the effects. The second assumption of homoscedasticity was not met, showing a significant Q-value (Q = 123,16, p < .001). This indicates that the variances are not all the same and that there are real differences between studies. This might imply that the mean correlation of war-exposure on harsh parenting is affected due to the big differences between studies. The violation of the homoscedasticity assumption however must be severe to present a major problem (Statistics Solutions, 2013). This should therefore not cause
problems within this study.
An overview of the main findings of the articles show high, medium and low
correlations between war-exposure and harsh parenting. One of the fourteen studies found a high correlation (r = .53) between war-exposure and harsh parenting (Sriskandarajah et al., 2015). Five studies found medium correlations between war-exposure and harsh parenting. Both Al-Krenawi (2007) and Punamaki et al., (1997) found that war-exposure is positively correlated (r = .23) with harsh parenting. Another study found strong gender differences in the correlations between war-exposure and harsh parenting. The amount of war-exposure
correlated (r = .40) with the amount of harsh parenting for girls and (r = .25) for boys (Catani et al., 2009). Another study by Catani (2010) found that the experience of war increased harsh parenting (r = .38). A longitudinal study also found a medium correlation (r = .41) between war-exposure and an increase in harsh parenting (Punamaki et al., 1997).
In addition, a few low correlations were found between war-exposure and harsh parenting. The smallest correlation (r = .02) was found by Garbarino and Kostelny (1996) followed by Palosaari, Punamaki, Qouta, & Diab (2013) with a correlation of (r = .04). Another small correlation of (r =.06) was found by Cummings et al., (2010) and (r =.09) by (Bryce et al., 1989). Final, low correlations between war-exposure and harsh parenting were found for boys (r =.09) and for girls (r =.08) (Barber, 1999)
The mean correlation between war-exposure and harsh parenting was highly significant (r = .26, p < .001), Families who are war exposed, are more likely to use harsh parenting strategies. The statistical significance indicates that the relation between war-exposure and harsh parenting is caused by something other than random chance. The findings show that war intensity explains around 1.5% of the variance in the association between war-exposure and harsh parenting (r² = .015), leaving 98.5% of the variance unexplained. This means that, in addition to war-exposure, parents’ level of harsh parenting is explained by other factors.
After assessing all studies included, one study was found reporting war-exposure and overprotective parenting. The amount of war-exposure shows a significant but small negative correlation with overprotective parenting (r = -.09, p < .001). This indicates that war-exposure is associated with less overprotective parenting. Being personally exposed to war shows no correlation with overprotective parenting (r = .00, p > .05), indicating that being personally exposed to war makes no significant contribution to overprotective parenting (Dekel & Solomon, 2016). Since only one study reported on war-exposed families and overprotective parenting, this framework remains statistically unexamined and cannot be meta-analyzed. Risk of Bias Across Studies
To check for publication bias a funnel plot was created and visually inspected for the data set. Figure 5 shows the funnel plot with the war-exposure and harsh parenting effect sizes on the X-axis and the standard error on the Y-axis. The funnel plot appears asymmetrical,
Egger’s regression showed no significant asymmetry (t = .97, df = 13, p = .35), which indicated there is no publication bias. Also, to check for missing studies the trim and fill procedure was used. Following this procedure, using the Rosenthal approach, it appeared there was no publication bias (fail-safe N = 2196, p < .0001). A high fail-safe N indicates that even a lot of nonsignificant studies may not have influenced the statistical significance of the meta-analytic results (Oswald & Plonsky, 2010).
Discussion
This meta-analysis investigated whether war-exposure is related to harsh and/or overprotective parenting. The 14 studies included show that parents of families who are exposed to war, more often show harshness towards their children. Therefore, the hypothesis that there is a positive association between war-exposure and harsh parenting is accepted. Although a thorough examination among the peer-reviewed published literature has been done, only one study reported on overprotective parenting after the experience of war. In this study, war-exposure shows a highly significant, but very small, negative correlation with overprotective parenting. This indicates that war-exposure is related to less overprotective parenting. Due to insufficient data, the hypothesis that there is a positive association between war-exposure and overprotective parenting could not be answered.
Several findings may help explain the results. The results of war-exposed families and harsh parenting will be discussed first. It is thought that several family characteristics might influence the relation between war-exposure and harsh parenting, since moderators may mask correlations that are weaker or stronger in some subgroups of families. First, parental gender could be a factor that might influence the relation between war-exposure and harsh parenting. This may have resulted in alternative findings since mothers and fathers could be affected differently by war (Wieling et al., 2015). For example, the civil war in Sri Lanka increased alcohol use and higher levels of harsh parenting by fathers and not mothers. Another study
found that war-exposure increased harsh parenting with fathers and decreased with mothers (Palosaari et al., 2013). The correlation between war-exposure and harsh parenting might be stronger for fathers than for mothers. Therefore, parents’ gender might be a variable that modifies the relation between war-exposure and harsh parenting. More research however is needed to asses this relation.
In addition, a possible factor that might modify the relation between war-exposure and harsh parenting is the child’s gender. It might be that the correlations are weaker or stronger in some boy’s or girl’s families. Differences were found between parents in their use of harsh parenting given their child’s gender. According to one study, parents showed harsher
parenting towards boys than girls (Punamaki et al., 1997). In contrast, it was also found that the experience of war was related to an increase in parental use of harsh parenting with girls, but unrelated to harsh parenting behaviors with boys (Barber, 1999). Strong gender
differences in the correlations between war-exposure and harsh parenting were also found, where war-exposure correlated highly with the amount of harsh parenting for girls (r= .40) and medium high for boys (r = .25) (Catani et al., 2009). Due to these inconsistencies, more research is needed to determine whether child’s gender is a factor that influences the relation between war-exposure and harsh parenting.
Third, ethnicity can be factors that modifies the relation between war-exposure and harsh parenting. Several studies have demonstrated that the cultural context can modify the links between war-exposure and harsh parenting (Al-Krenawi, 2012; Wieling et al., 2015). When an additional analysis was conducted following the method of Lipsey and Wilson (2001) using Mean ES macro’s for studies grouped by ethnicity, it appeared that harshness is more strongly associated with war-exposure in some ethnicities. The smallest correlation comes from Palestinian families. This does not correspond with the article’s assessment of war intensity as they report high amounts of war-intensity. The largest correlation between
war-exposure and harsh parenting comes from Sri Lankan families, as three out of the four studies with high correlations were conducted with Sri Lankan families. This corresponds with the article’s assessment of war intensity as they report high exposure to mass trauma. The possibility that ethnicity might influence the relation between war-exposure and harsh parenting is hereby considered. However, notable is that the studies with high correlations have a smaller number of participants compared to other studies included. This could have influenced the results.
Last, children’s age is a possible factor that modifies the relation between war-exposure and harsh parenting. It appeared that studies in the meta-analysis with children’s mean age below twelve years show a higher correlation with harsh parenting (r = .44, p < .001) than studies with children’s mean age above twelve years (r = .27, p < .001). This could indicate that war-exposed parents show more harshness towards children younger than twelve years than with older children. Therefore, it is possible that the age of children is a moderator in the relation between war-exposure and harsh parenting. However, it is possible that these
differences exist since the studies with the younger mean age were conducted in Sri Lanka, where the largest correlation between war-exposure and harsh parenting was found.
Since harshness is more exhaustively studied, there is more reason to pay attention to overprotectiveness in this study. One study reported on war-exposure and overprotective parenting, indicating that war-exposure is related to less overprotective parenting. This finding is of interest, as it contradicts the hypothesis. Due to insufficient data, the hypothesis regarding a positive association between war-exposure and overprotective parenting could not be answered. However, it is still thought there is a relation between the experience of war and overprotective parenting.
The following studies argue for an association between war-exposure and overprotective parenting, as they showed that traumatic events could lead to more
overprotective parenting. The first study found that parents of families exposed to bushfires tended to use more overprotective parenting practices (McFarlane, 1987). The second study found that parents of families who were higher exposed to a natural disaster, namely a tsunami, tended to use more overprotective parenting practices (Bokszczanin, 2008). The third study found that, in the aftermath of the September 11th terrorist attacks, overprotective
parenting increased (Henry, Tolan, & Gorman-Smith, 2004). Final, the statement that parental overprotectiveness can be interpreted as a reaction to threat (Henry et al., 2004), also speaks for a relation between war-exposure and overprotective parenting. The experience of war is threatening and traumatic (De Jong, 2002; Joshi & O’Donnell, 2003; Panter-Brick et al., 2009), and could therefore lead to more overprotective parenting.
Several limitations of this meta-analysis should be taken into consideration. The first limitation is that published studies are usually not representative of all research on a particular topic. This can mean that the effects of the included studies are overrated. Besides, this meta-analysis only used correlations from the studies included to calculate possible effect sizes. This resulted in four studies out of the fourteen, that could not contribute to the results, as they did not report on correlations. This might have affected the mean correlation of this meta-analysis. Also, the skewed distribution shows that there are more weaker correlations for war-exposure and harsh parenting. The higher correlations of some studies might have biased the mean correlations reported. Because of this, the reported mean correlation must be
interpreted with caution.
Second, the small number of studies included in this meta-analysis is a limitation that should be taken into consideration, since a small number of studies could lead to a limited power (Sterne, Gavaghan, & Egger, 2000). Another limitation to keep in mind is that within this meta-analysis it is not possible to draw causal relations between war-exposure and harsh parenting. This meta-analysis relied on correlations, and can therefore not imply a causal
relation between war-exposure and harsh and or overprotective parenting. A further limitation of this meta-analysis is that it is non-experimental. The evidence that war-exposed parents show harsher parenting behaviors cannot be confirmed in experimental studies, as it is not ethical to experiment with war-exposure and harsh parenting. Although we cannot prove a causal link through experimental studies, we have reasons to believe that it is war driving parents to harsher parenting.
Despite these limitations, our study presents its own strengths. This study was the first to meta-analyze whether war-exposure is related to harsher and/or more overprotective parenting. Another strength of this meta-analysis is that all studies were blindly double checked and coded by at least two trained researchers. This resulted in very good interrater reliability and is an asset in this meta-analysis as it makes the results more reliable. Another strength of this study is that the results are not subjected to publication bias. It is therefore not likely that the studies show an overrepresentation of significant studies as it is more likely for these studies to be published (Sterne et al., 2000).
This research has implications for future research and clinical practice. The results state the importance of investigating how to help war-exposed families best. There are many families who fled their countries, cities or homes because of war conditions. For example, the Syrian war, a global crisis which has created over four million refugees and left eight million people internally displaced (Jefee-Bahloul Barkil-Oteo, Pless-Mulloli, & Fouad, 2015; Khalil, 2013; Nassan, Frye, Adi, & Alarcon, 2015). Therefore, the finding that parents tend to be harsher after the experience of war is a cause for concern. For clinical practice, this finding suggests that more help might be needed to support war-exposed parents. It could help to make both intervention workers and parents more aware of the relation between war-exposure on harsh parenting. It may also contribute to gaining more insight into the risks that the experience of war brings for parents’ harsh parenting practices.
The findings may also have implications for understanding the relation between war-exposure and overprotective parenting. Due to a lack of empirical studies it was not possible to determine whether war-exposure contributed to overprotective parenting. Only one study was conducted. The negative correlation noted in this study indicates that war-exposure is related to less overprotective parenting. Nonetheless, it is too early to tell whether the
experience of war is related to overprotective parenting because so far it is only been studied once. It is thus not possible to draw conclusions on war-exposure as to its consequences for overprotective parenting.
However, it appears to be common for children to develop internalizing problems after the experience of war. Since children’s internalizing problems can lead to overprotective parenting it might be likely that the experience of war could lead to more overprotectiveness (Lieberman et al., 2011; Rubin et al., 2002). A greater understanding of this matter is
therefore relevant since overprotective parenting can stimulate different risk behaviors in children and can negatively influence child development (Bayer et al., 2006; Bayer et al., 2009). This highlights the importance of future studies to investigate whether war-exposed parents tend to more overprotective parenting practices.
Last, several family characteristics, such as the parents’ gender, the child’s gender, the child’s age and ethnicity might influence the relation between war-exposure and harsh
parenting. More research regarding possible moderators is recommended to clarify the current knowledge of what affects the relation between war-exposure and harsh parenting. These moderators might mask correlations that are weaker or stronger in some subgroups of families.
Conclusion.
To conclude, this meta-analysis shows that parents of families who are exposed to war, more often show harshness towards their children. Additional research is recommended to
investigate possible moderators that affect the relation between war-exposure and harsh parenting. The results also show that although a thorough examination among the peer-reviewed published literature has been done, only one study on war-exposure and
overprotective parenting was found. This finding indicates that war-exposure is associated with less overprotective parenting. More research is needed to determine if parents who are exposed to war are more likely to adopt an overprotective parenting style.
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Figure 5. Funnel plot after trim and fill procedure. On the X-axis the war-exposure and harsh parenting effect sizes and on the Y-axis the standard errors
Table 1
Descriptive statistics of Overall effect size of War-Exposure on Harsh Parenting
Lead author Study type Ethnicity M N Exposure Reported by r
Al-Krenawi (2007) Longitudinal Palestinian 15.4 2328 High Child .23
Barber (1999) Cross-sectional Palestinian - 3462 High Boys .09
- 3462 High Girls .08
Bryce et al., (1989) Cross-sectional Middle East - 152 Medium Mother .09 Catani et al., (2008) Cross- sectional Sri Lankan 12.2 296 Medium Child - Catani et al., (2009) Cross-sectional Afghan 11.8 165 High Boys .25
Cross-sectional Afghan 11.8 122 High Girls .4
Catani et al., (2010) Cross-sectional Sri Lankan 13 1049 Medium Child .38 Cummings et al., (2010) Cross-sectional Irish 12.1 700 Medium Child .06 12.1 700 Medium Mother .04 Cummings et al., (2012) Cross-sectional Irish 12.3 299 Medium Child - Garbarino et al., (1996) Cross-sectional Palestinian - 150 High Mother .02 Olema et al., (2014) Cross-sectional Ugandan 14.0 50 Medium Child - Palosaari et al., (2013) Longitudinal Palestinian 11.4 240 High Child .04 Punamaki et al., (1997) Cross-sectional Palestinian 11.5 108 High Child .41
Punamaki et al., (2001) Longitudinal Palestinian 14.4 86 High Child .33 Longitudinal Palestinian 14.4 86 High Child .23 Quota et al., (2007) Longitudinal Palestinian 17.6 65 High Parent - Sriskandarajah et al.,(2015) Cross-sectional Sri Lankan 9.2 359 Medium Child .53
Table 2
Descriptive statistics of Overall effect size of War-Exposure on overprotective Parenting
Lead author Study type Ethnicity M N Exposure Reported by r
Dekel and Solomon (2016) Cross-sectional Israeli 13.5 2858 - Child -.09
Note. M= children’s mean age; N= number of participants; Exposure= level of war-exposure; r= effect size of war-exposure on overprotective parenting
