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2012 17: 1011 originally published online 17 January 2012J Health PsycholFernando Santana Paiva, Ronaldo Rocha Bastos and Telmo Mota Ronzani

Parenting styles and alcohol consumption among Brazilian adolescents  

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Journal of Health Psychology17(7) 1011 –1021© The Author(s) 2011Reprints and permission: sagepub.co.uk/journalsPermissions.navDOI: 10.1177/1359105311428535hpq.sagepub.com

Introduction

Adolescence, one of the most important periods of human development, is characterized by rapid physical, psychological and social transforma-tions. Adolescence is a period of personality consolidation, focusing on self-concept, self-esteem formation, and the ongoing development of cognition (Meteyer & Perry-Jenkins, 2009; Suchman, Pajulo, Decoste & Mayes, 2006). In adolescence individuals begin a journey of inde-pendence from their parents as they develop their own complex social networks. They adopt new and significant roles, choose a profession, form affective and sexual relationships, and initiate potentially risky behaviors such as alcohol use (Carretero & Léon, 2004; Kuntsche & Stewart, 2009; White & Halliwell, 2010).

Because they experience a period full of intense psychosocial transformations, adoles-cents are vulnerable to hazardous behaviors such as alcohol abuse, something that has been underscored by the latest Brazilian epidemio-logic studies (Carlini, Galduróz, Noto & Nappo, 2005; Laranjeira, Pinsky, Zaleski, & Caetano, 2007; Guo, Hawkins, Hill & Abbott, 2001).

Parenting styles and alcohol consumption among Brazilian adolescents

Fernando Santana Paiva1, Ronaldo Rocha Bastos2 and Telmo Mota Ronzani2

AbstractAim: This study evaluates the correlation between alcohol consumption in adolescence and parenting styles of socialization among Brazilian adolescents. The sample was composed of 273 adolescents, 58% whom were males. Instruments were: 1) Sociodemographic Questionnaire; 2) Demand and Responsiveness Scales; 3) Drug Use Screening Inventory (DUSI). Study analyses employed multiple correspondence analysis and logistic regression. Results: Maternal, but not paternal, authoritative and authoritarian parenting styles were directly related to adolescent alcohol intake. Conclusions: The style that mothers use to interact with their children may influence uptake of high-risk behaviors.

Keywordsadolescent, alcohol, parenting styles, parental monitoring, secondary prevention, students.

1Faculdade Machado Sobrinho, Juiz de Fora, Brazil2Federal University of Juiz de Fora, Juiz de Fora, Brazil

Corresponding author:Telmo Mota Ronzani, Federal University of Juiz de Fora, Rua Johann Strauss, 120. cond S?o Lucas. S?o Pedro, Juiz de Fora, 36036647, Brazil Email: telmo.ronzani@ufjf.edu.br

428535 HPQ17710.1177/1359105311428535Paiva et al.Journal of Health Psychology2011

Article

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1012 Journal of Health Psychology 17(7)

These studies found adolescents had depend-ence rates of 7 percent, lifetime use rates of 54.3 percent, and weekly binge drinking rates of 13 percent of all adolescents (17% of boys). Besides, among the youth who consume alco-hol in Brazil, 16 percent are binge drinkers, from these 21 percent are men and 12 percent are women (Schenker & Minayo, 2005; Simons-Morton, 2004).

In order to understand this behavior, several authors have pointed to the family as one of the main factors in this complex interplay, with an important role in the production of risk as well as protective factors (Cecconelo; Antoni; Koller, 2003; Newman et. al., 2008) This may be explained by the fact that many social behav-iors, possibly including the use of psychoactive substances, are predominantly learned from interactions between youth and their primary socialization sources, which in the western world are mainly family, school and peers (Schenker and Minayo, 2005; Shope et al., 2001; Simons-Mortons, 2004).

The constant interaction between parents and child communicates a set of rules. Perceived dif-ficulties in these social interactions can introduce serious risk factors for development (Costa, Teixeira and Gomes, 2000; Glasgow, Dronbush, Troyer, Steinberg and Ritter, 1997; Jackson C, Henriksen L, Dickinson D, 1999; Kuntsche and Stewart, 2009; Suchman, Pajulo, Decoste & Mayes, 2006; Shuckmith, Glendiming & Hendry, 1997; White & Halliwell 2010).

The landmark works by Baumrind (1966, 1971) and Maccoby and Martin (1983) described parenting styles of socialization and linked them with the use and abuse of psychoactive substances among adolescents. According to Maccoby and Martin (1983), parenting styles are defined as a function of two underlying dimen-sions: demandingness (control) and responsive-ness (support/affect). According to this concept, a typology of four parenting styles may be recog-nized. Authoritative parents are characterized by being highly demanding and affectively involved with the children at the same time. Authoritarian parents may be understood as they demand a lot

and offer little affect, that is, their demands are out of keeping with their acceptance of their chil-dren’s demands. The permissive-indulgent type demands little responsibility and maturity, allow-ing the children to monitor their own behavior. Finally, uninvolved parents are understood as having a permissive and indifferent behavior, with a low degree of control of and affect towards the children (Maccoby and Martin, 1983).

Compared to uninvolved, authoritarian, indulgent parents, numerous studies have found that authoritative, non-permissive parenting style is positively correlated with less use of alcohol and other drugs among adolescents (De Michelli and Formigoni, 2000; Maccoby and Martin, 1983). In addition, studies in Europe and the United States found that authoritarian educa-tional approaches had an effect on reducing the odds for the substance use among Hispanics and Asians. These findings suggest that cultural dif-ferences may influence parenting styles, as well as the values about alcohol and other drugs use among young people. (Cohen & Rice, 1997; Radziszewska et. al., 1996).

The goal of the present study was to under-stand the relationship between alcohol use and parenting styles among adolescents in Brazil, in order to better understand cultural differences related to this behavior among brazilian adolescents.

Materials and methods

Participants

The study involved 273 adolescents, aged from 14 to 19 years, attending one of three State-run secondary schools in the municipalities of Juiz de Fora and Rio Pomba in the state of Minas Gerais, Brazil. The sample was constructed from a list with the names of all students enrolled in second-ary education at each institution. EpiDat (3.1 ver-sion) was used to randomly select students to be invited to take part in the research. The sample was stratified according to gender and school year and strata sizes were constructured propor-tional to the entire population distribution.

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Principals of the schools were informed about the aims of the study and authorized data collec-tion. In order to be included in the study, each student: 1) provided oral informed consent; 2) was present in the classroom at the time of data collection; 3) completed 90 percent of study sur-veys. The project was submitted to and approved by the Ethics and Research Council of the Federal University of Juiz de Fora, Minas gerais, Brazil (document n° 0174.0.180.000-07).

Data collecting procedures

The questionnaires were administered in April 2008. Students were informed of study proce-dures, and asked for oral consent, in a private room. Instruments required 45 minutes to com-plete. After data collection, three individuals were excluded: two were over the study age limit (19 years old), and one did not fill in the instru-ments correctly. Twenty individuals were further excluded, once it was felt that the final sample should be composed of adolescents who reported they had knew both their father and mother. The final sample consisted of 250 subjects.

However, the number of responses used for analysis consisted of 186 and 200 cases for mothers and fathers, respectively. In 64 ques-tionnaires about mothers and 50 about fathers, demandingness or responsiveness scores coin-cided with the median and were excluded from calculations (Newman et. al., 2008). Rationale provided under Instruments, below.

Instruments

Sociodemographic Questionnaire. This assessed the socioeconomic profile of the participants including gender, age range, schooling year, family income, housing, religion, and presence or absence of parents who are heavy drinkers.

Responsiveness and Demandingness Scales. This instrument was used to define the four parenting styles studied (authoritative, authoritarian, unin-volved and indulgent). This scale is composed of six questions on parental demandingness and ten

questions on parental responsiveness, according to the theoretical model proposed by Maccoby and Martin (1983). All questions are assessed as a 3-point Likert scale. Demandingness and respon-siveness scales were used by Lamborn, Mounts, Steinberg and Dornbusch (1991) in a study that investigated the relation between parenting styles and competence and adjustment patterns during adolescence. They were validated for the Portu-guese/Brazilian context by Costa, Teixeira and Gomes (2000), who used the median value to dis-criminate between high and low values of the demandingness and responsiveness dimensions.

Drug Use Screening Inventory - (DUSI). This screening instrument, adapted to and validated for Portuguese/Brazil by De Micheli and For-migoni (2000), was used to assess alcohol intake among the subjects. The inventory assesses the frequency of alcohol intake during the month preceding survey administration, through an item with the following possible answers: a) did not use; b) once or twice; c) 3 to 4 times; d) 5 to 9 times; e) 10 to 15 times; f) 16 to 20 times; g) more than 20 times. Binge drink-ing was assessed in a similar manner with the following responses: a) no dose; b) 1 to 2 doses; c) 3 to 4 doses; d) 5 to 9 doses; e) 10 to 15 doses; f) 16 to 20 doses; g) more than 20 doses.

Data analysis

The collected data were organized and entered in the SPSS statistics software (version 15.0). Descriptive analyses defined frequencies, per-centages, means, medians, and standard devia-tions. Multiple correspondence analysis was used for exploratory analysis in order to iden-tify association trends between the explanatory variables and the outcomes. Finally, we con-ducted logistic regression analyses between all covariates and the dichotomous outcomes: drank/did not drink and binge/no binge, in an attempt to rank the set of independent variables significantly associated (p < 0.05) with the dependent variables. Throughout the analysis process we sought the best explanatory model

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for the set of data found and assessed the degree of effect of the variables over the outcomes.

Results

Table 1, describes our sample. Most (58%) of the students were male. Approximately 62% were over 16 years of age, and 46% attended the first year of secondary school at the time of data collection. Most individuals lived with their parents (65.2%), 34.8% lived with other students or with relatives, and 7.6% reported that father and/or mother were heavy drinkers or addicted to alcohol.

After an exploratory analysis of all variables we undertook a dichotomous logistic regression anal-ysis using multiple correspondence analysis in the exploratory step with the two study outcomes, drank and binge, as dependent categorical varia-bles (supplementary points in CA). Explanatory variables that were not significantly correlated with outcomes (p < 0.05) were eliminated from further analyses. These included religion, father’s/mother’s schooling, family income, and father/mother who drank or were addicted to alcohol, once the correlation between them and the out-comes studied were not statistically significant.

After this step, another multiple correspond-ence analysis with the remaining variables was performed with maternal and paternal parenting styles separated. Dimension 1 in Figure 1 shows the separation between subjects with opposite alcohol intake behavior (drank/did not drink, binge/no binge). As found in other studies, a maternal authoritative style was correlated with the absence of alcohol intake by the adolescent. Alcohol abstinence was also associated with female gender, younger age (14 and 15 years), and parents in the household. Conversely, alco-hol intake correlated with the other maternal parenting styles (uninvolved, indulgent and authoritarian), in addition to a number of other variables, including household without the par-ents, male gender, older age (17 to 19 years), and attendance to the third year of secondary school. Dimension 2, subjects with a higher family income and mothers with more

schooling years were not linked to those with lower income and mothers with fewer years of formal education (see Figure 1).

Table 1. Characterization of Dependent and Independent Variables

Variables F %

Gender Male 146 58.4 Female 104 41.6Age (years) 14 e 15 97 38.8 16 79 31.6 17 a 19 74 29.6Schooling Year 1st 115 46.0 2nd 63 25.2 3rd 72 28.8Familiar Income (US$) 340 - 1020 72 28.8 1021 - 1700 90 36.0 1701 - 3400 58 23.2 > 3400 30 12.0Father’s Education Secondary 153 61.2 Undergraduate incomplete 27 10.8 Undergraduate complete 57 22.8 Not informed 13 5.2Mother’s Education Secondary 143 57.2 Undergraduate incomplete 21 8.4 Undergraduate complete 79 31.6 Not informed 07 2.8Housing Live with both parents 163 65.2 Do not live with both parents 87 34.8Religion Yes 203 81.2 Not 47 18.8Father/mother heavy drinker Yes 19 7.6 Not 231 92.4Alcohol use (last month) Yes 140 56.0 Not 110 44.0Binge drinking Yes 77 30.8 Not 173 60.2

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Paiva et al. 1015

Authoritative and indulgent styles remained associated with the abstinence and absence of binge drinking (Figure 2, Dimension 1). Female gender, younger age and parents in the house-hold followed the same trend shown in Figure 1. Unexpectedly, uninvolved and authoritarian paternal parenting styles were closer to and directly correlated with alcohol use, as well as male gender, household without the parents and older age (see Figure 2).

We entered all significant variables into multiple logistic analyses conducted separately for the parenting styles of fathers and mothers (see Table 2). Paternal socialization style was not significantly related alcohol use or binge drinking. Maternal authoritative and authori-tarian parenting styles were protective against adolescent alcohol intake. To illustrate: the 0.39 odds ratio (OR) for authoritative

style signifies that an adolescent with an authortative mother has a 39% risk of alcohol intake, or 61% protection, compared to an ado-lescent with an uninvolved mother. In addition to parenting style, age is an important risk fac-tor for alcohol intake. Compared to older respondents (17 to 19 years old) younger ado-lescents (14 to 15 years old) had 34% of the risk for consuming alcohol.

Last, maternal parenting style, and respond-ent age, and having a two-parent household are all significantly related to binge drinking (Table 3).

Discussion

Alcohol consumption has been recognized as a serious public health problem in numerous countries. In agreement with previous reports

Dimension 1

2,01,51,0,50,0-,5-1,0

Dim

ensi

on 2

1,5

1,0

,5

0,0

-,5

-1,0

-1,5

Maternal Style

Age

Household

Frequency Dusi

Binge

Drank

Schooling year

Gender

uninvolved

indulgent

authoritarian

17 to 19

16

14 to 15

does not live with the parents

Live with the parents

More than 20 times

5 to 20 times

1 to 4 times

Did not use

Not bingeauthoritative

binge

Did not drink

drank

3rd year

2nd year

1st year

Male

Female

Figure 1. Multiple correspondence analysis of the set of variables concerning the maternal parenting style

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1016 Journal of Health Psychology 17(7)

Table 2. Binary Logistic Regression of alcohol intake

Variables Maternal Parenting Style

Odds Ratio 95% CI

Authoritative 0.39 0.19 – 0.83Authoritarian 0.81 0.33 – 1.99Uninvolved 1.00 14 and 15 years 0.34 0.15 – 0.7517 to 19 years 1.00

Source: Author

Table 3. Binary Logistic Regression of binge drinking

Variables Maternal Parenting Style

Odds Ratio 95% CI

Authoritative 0.47 0.20 – 1.09Authoritarian 0.32 0.10 – 0.87Uninvolved 1.00 14 and 15 years 0.22 0.05 – 0.9517 to 19 years 1.00 Live with the parents 0.47 0.23 – 0.94Not to live with the parents

1.00

Source: Author(Newman, Harrison, Dashiff and Davies, 2008; Paiva and Ronzani, 2009), we found that the family plays an important role in adolescent alcohol use. Specifically, authoritative mothers reduce adolescent odds for alcohol use, as com-pared with non-authoritative mothers, which confirms research undertaken in other social

and cultural contexts (Jackson, Henriksen and Dickinson, 1999). The authoritative parenting style is based on a balance between high parental demandingness and responsiveness towards the

1,51,0,50,0-,5-1,0-1,5

1,5

1,0

,5

0,0

-,5

-1,0

-1,5

Household

Drank

Binge

Age

Paternal Style

Frequency Dusi

Schooling Year

Gender

does not live with the parents

Live with the parents

Did not drink

drank

Not bingebinge

17 to 19

16

14 to 15

uninvolved

indulgent

authoritarian

authoritative

More than 20 times

5 to 20 times

1 to 4 times

Did not use

3rd ano

2nd year

1st yearMale

Female

Dimension 1

Dim

ensi

on 2

Figure 2. Multiple correspondence analysis of the set of variables concerning the paternal parenting style

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Paiva et al. 1017

children, favoring the expression of parenting practices such as bidirectional communication, effective monitoring, support and involvement, all with the potential to significantly protect against adolescent alcohol use and abuse (Fletcher, Steinberg and Wheeler, 2004).

The maternal authoritarian style is also pro-tective against binge drinking. This may be important, once such maternal stance may be understood as not so hazardous in the Brazilian culture, being even beneficial regarding lower alcohol intake and the avoidance of other health hazardous behaviors, a finding that points to important cultural differences permeating the relationship between parents and children (Broman, Reckase and Freedman-Doan, 2006). In the Latin culture, a control and authority-centered role model may still be positively accepted, something that is rejected in other cultures, such as those from the Anglo-Saxon countries (Cohen and Rice, 1997).

It is noteworthy that the set of socialization goals and practices discussed by Darling and Steinberg (1993) must be added to the analysis and observation of parenting styles. Socialization goals may contribute to the understanding of how different parenting styles yield similar results for different outcomes. Parents may have specific educational values and goals that they wish to nurture in their children (Bem and Wagner, 2006). Once the authoritarian and authoritative styles were found to be protective, one may assume that besides the role played by the parenting style these mothers have estab-lished a lower level of alcohol involvement as a socialization goal, with the understanding that this is one element in the list of values to be implemented. Such consideration may also help with the understanding that different parenting styles may be important protective factors. Therefore, the parenting styles of socialization in our sample (authoritative and authoritarian), must be positively understood, as they not only protect against alcohol use, but may also signifi-cantly contribute to lower exposure to the risks of alcohol consumption and/or delay adolescent alcohol exposure till an older age.

As for the maternal uninvolved and indul-gent styles, our results are in agreement with those from other studies (Simons-Morton, 2004; Schuckmith, Glendiming and Hendry, 1997), which indicated a significant association between these styles and more unfavorable out-comes of adolescent alcohol consumption. Both styles are characterized by low control and per-missiveness, which may relate to low or inade-quate monitoring and supervision of the children’s activities. The consequent difficulty to know what the children do and with whom they relate, leads to a relationship where there is no dialogue or support, something that does not effectively help the adolescent’s psychosocial development (Fletcher, Steinberg and Wheeler, 2004).

Another important point of our study was the significant presence of the mothers in the com-plex process of adolescent alcohol intake behavior, contrasting with the lack of correla-tion with the presence of the fathers. The ado-lescents’ perception of the importance of the maternal parenting style may indicate a greater involvement of the maternal figure with the care of the youth and the protection against health hazardous behaviors, such as the use of pyschoactive drugs, risky sexual behavior and violence, among others. Concern about the chil-dren’s well-being, monitoring, supervision, involvement and emotional support may still be linked to the perceived maternal role within the household, thus explaining the significant pres-ence of the mother as a protective factor against adolescent alcohol use we found.

According to some authors (Ariés, 2006; Arriagada, 2000; Biasoli-Alves, 2000; Machado, 2001; Scavione, 2001), delegating offspring care to mothers is a historical and social construct. This holds true for Brazil, where material provision and offspring protec-tion has traditionally been assigned to the father. Although the last decades have certainly wit-nessed a series of transformations in these roles, the marriage contract has maintained a great degree of continuity (Biasoli-Alves, 2000) through which the woman is responsible for the

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traditional household chores (child and home care) and the man is the provider of material resources (Scavione, 2001).

Overall, adolescents rated fathers lower in terms of both demandingness and responsive-ness, compared with mothers. Fathers may be less involved in monitoring, supervision and support, which are all considered protective against adolescent alcohol and drug use and abuse. However, because the paternal parenting styles did not explain the outcomes analyzed, it may be assumed that the father’s influence (as a risk or protective factor) on adolescent alcohol consumption behavior may not be related to such parenting socialization practices or atti-tudes. In fact, other factors not assessed in our study, such as paternal alcohol intake pattern, parents’ beliefs about and expectations towards alcohol consumption, and specific communica-tion about alcohol use, may all be very impor-tant variables for the definition of adolescent alcohol use behavior (Bryant, McDermott, Zapata, Forthofer, Brown and Chewey, 2006).

Because men are still the largest alcohol consumers (Laranjeira, Pinsky, Zaleski & Caetano, 2007), such behavior may not be seen by the fathers as a problem, something that may be differently perceived by the mothers as clearly hazardous and directly related to the child’s body and mind care. It may also be sup-posed that because alcohol use is not seen by the fathers as a socialization goal value, they may become more worried about the children’s professional career and job market, leaving health care entirely to the mothers, or adopting irrelevant postures and strategies (Bem and Wagner, 2006; Darling and Steinberg, 1993).

It is noteworthy that different family arrange-ments have been constructed and solidified in the Brazilian social, economical and cultural environments. The presence of the rigid father-mother-child triad has been gradually reduced in such arrangements. Although the massive access of women to higher education and the job market has reshaped these household rela-tions, and forced men to redefine their responsi-bilities within the family, women are still

subject to double work shifts, something that may give rise to domestic conflict and unfa-vorable outcomes regarding the psychosocial development of children and adolescents. Grandparents, uncles and aunts who help with children’s care is a common finding, as is the existence of single-parent families, with a growing percentage of single women as the only ones responsible for socialization, educa-tion and care of the children, with a strong impact on the social policies and services, which must effectively understand and meet the real needs of the Brazilian families (Arriagada, 2000; Reis, 1994).

A single, exclusively individual, adolescent-targeted outlook is not enough to precisely understand adolescent alcohol consumption and other health hazardous behavior, in order to inform the implementation of more effective public policies. The different actors and institu-tions that make up the social and cultural fabric must be involved, so as to unveil the way a complex interplay of factors can shape the adoption of behaviors such as alcohol use and abuse (Traverso-Yépez and Pinheiro, 2002).

Our study has some limitations. Because it was a cross-sectional study, our findings are correlational. Future studies should explore these relationships to identify whether causal relationships exist between parenting style and adolescent drinking. Furthermore, because our study assessed only the adolescents’ percep-tions of parenting styles, there was no com-parison with the parenting styles as perceived by the parents themselves or by behavioral raters.

Final considerations

Our findings suggest that maternal parenting style may help explain risks for adolescent drink-ing in Brazil. Fathers’ style appeared unrelated.

The presence and importance of the mother in the interplay of factors affecting adolescent alco-hol intake becomes relevant for the planning, implementation and assessment of promotive, preventive and treatment strategies aimed to

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Paiva et al. 1019

reduce adolescent alcohol intake and risk expo-sure time. Mothers have been traditionally and systematically involved in health education ini-tiatives developed by health services, with fathers playing a reduced or insignificant role. There are several reasons that can account for this, such as paternal negligence, mother’s tradi-tional leadership role in child care, lack of inter-est and/or organizational capacity of the health services to guarantee and/or stimulate a more effective participation of fathers in child care, and the organization of work that frequently hampers an effective participation of fathers in child care. Although we did not identify links between paternal style and child drinking out-comes, other paternal influences on child aca-demic, psychosocial and emotional have been reported (DiClemente et al.,2001; Guo, Hawkins, Hill & Abbott, 2001).

It may be fundamental to increase the mater-nal involvement in the processes of health and education, so as to promote the adoption of favorable behaviors and prevent the development of behaviors that jeopardize the integral develop-ment of adolescents. Through the improvement of their socialization practices and strategies, fathers should also be involved in these processes, in order to strengthen the protective force of the family institution against the use and abuse of psychoactive drugs. Actions that raise parents’ awareness of their important role in the psycho-social development of their children, and in the consolidation of favorable beliefs, values and attitudes, may be very effective. Specifically, adolescents who perceive they get more support, who feel understood by their families, and have parents who discipline in a respectful way that supports autonomous thinking, show lower rates of drug and alcohol use and abuse. It is thus important that family-targeted actions be under-stood and implemented through a cooperative outlook, not excluding certain actors and/or assigning specific tasks to each family member, once such rigid and immutable roles have been increasingly questioned. Providing dialogue, information exchange and knowledge for all the involved actors (father, mother, children and

others) may positively impact the health promo-tion of the whole family group.

Intervention projects targeting these groups (adolescents, family) deserve permanent atten-tion and interest, with participation and interac-tion of different knowledge fields, once interdisciplinary, intersectorial, integral work may shed light on the best line of action to be taken, contributing to the autonomy and empowerment of subjects and social groups. The responsibility for health hazardous behav-iors must be shared among public professionals and managers, economists, social assistants, educators, cultural agents, judicial workers and health workers, who, along with adolescents, parents and all society are key to overcoming such a serious problem as the use, abuse and dependence of alcohol and other drugs. Neither is there a single agent responsible for the prob-lem, nor are some specific actors to blame. On the contrary, responsibility sharing and joint construction of alternatives are believed to be the best way forward.

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