Correlation between self-efficacy, parental parenting patterns, and severe depression in adolescents

Abstract

BACKGROUND

Adolescence is a critical period marked by significant psychological changes. This study explores how self-efficacy and parental parenting styles may influence the risk of severe depression among teens. The hypothesis is that higher self-efficacy and authoritative parenting patterns will be negatively correlated with severe depression in adolescents.

AIM

To investigate the correlation between self-efficacy, parenting patterns and major depression in adolescents, and to provide guidance for mental intervention.

METHODS

Using a cross-sectional survey design, the data were collected through a questionnaire survey. Patients with major depression and healthy adolescents in the hospital control group were selected as the study objects. The General Self-Efficacy Scale, the Parenting Style Evaluation Scale, and the Beck Depression Inventory were used as research instruments. Data input and statistical analysis were performed, including descriptive statistics, correlation analysis, through SPSS software.

RESULTS

The study found that depressed patients had significantly lower self-efficacy than healthy controls, and parenting style was significantly associated with depressive symptoms in terms of emotional warmth and understanding, punishment severity, and denial. Specifically, parental emotional warmth and understanding were significantly negatively associated with depressive symptoms, while parental punishment severity and denial were significantly positively associated with depressive symptoms. Self-efficacy showed a significant negative correlation with depressive symptoms, indicating that higher self-efficacy had lower depressive symptoms.

CONCLUSION

Adolescent major depressive disorder patient was significantly associated with their parenting style and self-efficacy. Higher self-efficacy is associated with decreased depressive symptoms, so improving adolescent self-efficacy and improving parenting style are important.

Key Words: Adolescent depression; Self-efficacy; Parental parenting patterns; Correlation analysis; Psychological interventions

Core Tip: This investigation delineates a significant correlation between adolescent major depressive disorder and parental rearing practices, emphasizing the beneficial impact of parental warmth and understanding, in contrast to the adverse consequences of punitive parenting. The study accentuates the mitigating influence of self-efficacy on depressive symptoms, thereby advocating for targeted interventions to enhance these protective factors and promote psychological well-being. Consequently, the research advances a dual-pronged approach, which simultaneously addresses the amelioration of depressive symptoms and cultivates a resilient, supportive milieu for adolescents, thereby fostering enduring psychological health.

INTRODUCTION

Adolescent depression refers to a kind of mental diseases characterized by continuous and significant emotional loss and loss of interest[1]. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition[2] specifically mentions that children and adolescents depression may have special symptoms, in terms of physical fitness, it may not meet the corresponding physical standards; in terms of emotion, adolescents can be manifested as emotional instability and irritability, rather than sadness. Mullen[3] pointed out children and adolescents depressive symptoms can show symptoms different from adults, such as they will show palpitation, chest tightness, numbness of hands and feet and other physical discomfort symptoms, but with the growth of age, its symptoms will gradually close to adult depressive symptoms[4]. Because the psychological development of adolescence is not mature, their clinical manifestations often appear with atypical characteristics[5], such as academic failure, social disorders, etc., their performance is often mistaken for the normal phenomenon[6,7] in adolescence. Other studies show that adolescent depressive symptoms include four symptom dimensions: Physical symptoms, irritability, cognitive symptoms and anhedonia, which are significantly different from adults[8]. Therefore, often lead to early adolescent depression is difficult to identify, treatment effect is bad, poor prognosis, and prone to serious behavior such as suicide, incidence increased year by year, serious harm to adolescent physical and mental health, in recent years some scholars research application of adolescent autism depression symptoms assessment scale can be used as screening adolescent depression symptoms[9], but the etiology and pathogenesis is unknown. The relationship between general self-efficacy and depression (self-efficacy) refers to the subjective judgment of their ability, that is, the degree of confidence, that is, when an individual has a goal, the individual determines whether he has the ability to complete the goal. It is a very important variable that influences its individual self-regulation. This concept was first proposed by Bandura[10], a famous American psychologist, and it is the most core concept in Bandura’s social cognitive theory. General self-efficacy plays a very important role in the dynamic psychological process of individuals performing target activities. Wood and Bandura[11] have suggested that general self-efficacy is based on cognitive process, behavioral choice, emotional process, and motivational effort to influence individual mental activities. In 1986, Bandura, in his book social foundation of thought and behavior: Theory of social cognition, summarized the three functions of general self-efficacy, as follows: Influencing people’s emotional response patterns and thinking patterns; influencing individuals’ behavioral choices; and determining the durability of people’s implementation of tasks[12]. It is believed that general self-efficacy plays a role in depression[10], which is the ineffective of individuals in the face of their own goals beyond their own ability. That is, the individual set a goal for himself, but the individual judgment 10 cannot be achieved by their own ability, that is, when the general self-efficacy is low, the individual will produce frustration and depression[10,13]. Studies believe that this way is related to the theory of self-difference, the self-difference theory namely adolescent reality-ideal self-difference, when reality and ideal, patients on their set goals can be complete, on the contrary, when the adolescent individual reality and ideal gap is larger, patients in the ideal is ineffective, there will be emotions such as depression, depression level with the rise of reality-ideal self-difference rise, but the speed with the increase of general self-efficacy and slow[14]. Adolescent general self-efficacy level regulates the relationship between reality-ideal self-differences and depression. Some foreign scholars have concluded that the general level of self-efficacy of depression is low[15-17]. Some scholars have examined depression and general self-efficacy and concluded that self-efficacy may be one of the important influences on depression[18]. Wang et al[19] showed that general self-efficacy mediated the role between depression and other factors; therefore, improving the general self-efficacy of patients has very positive significance to alleviate depressive symptoms. On the relationship between general self-efficacy and depression, the results of domestic and foreign studies are more consistent. In general self-efficacy, the general self-efficacy is emotional regulation, which refers to the ability or confidence that individuals can well regulate their emotional state. It will act on behaviors by affecting motivation, cognition, emotion and decision-making, and then affect the mental health level of individuals. Therefore, the general self-efficacy of emotional regulation plays a very important role in regulating individual behavior and personality[20]. Conversely, negative emotions gradually increase when individuals feel powerless to get rid of repeatedly thinking about negative events. In recent years, studies have confirmed that people’s confidence in doing something is higher, the stronger the efficiency of they do something, therefore, improve the depression emotional regulation of general self-efficacy, strengthen the confidence of the treatment, alleviate negative emotions has positive significance[21], emotional regulation of depression, the higher level of general self-efficacy, depression symptoms are lighter, and emotional regulation level of lower depression symptoms will be more serious, the two are closely related. Improving the general self-efficacy of emotion regulation is important for reducing depressive symptoms[22,23]. Parenting style is a combination of parents ‘parenting concepts, parenting behavior and their emotional expression of their children. It is a relatively stable behavior style and behavior tendency, which centrally reflects parents’ attitude towards their children and their educational concepts[24,25]. Parenting has different classification, is commonly used to distinguish the parenting into two dimensions: Parents (control) and reaction (warm), in turn into four types of breeding: Authority (high response), excessive doting (low demand high reaction), autocratic (high demand low reaction), neglect (low request low reaction). Psychologists at home and abroad used empirical research to explore the influence of parenting style on personality perfection, cognitive development and value formation of teenagers, as well as the characteristics and characteristics of parenting style and its influencing factors. Research shows that family education has a profound effect on children’s personal psychological development, and whether the correct parenting style adopted by parents largely determines whether children can grow up healthily[26]. Parents adopt an autocratic and neglect parenting style, their children are most prone to depression, they often lack competition, fear of authority, and often show low self-esteem, academic difficulties, behavioral problems, and internalizing symptoms[27]. The parents of teenagers with depression disorder lack due care, understanding and protection, and have more punishment, refusal and denial. In fact, such negative parenting style is easy to weaken the children’s confidence, so that excessive self-restraint, gradually initiation of helplessness, and then develop a sense of despair, negative attribution, leading to depression[28]. In conclusion, mental health during adolescence is crucial for their growth and development. Through in-depth research on the correlation between self-efficacy, parenting patterns and major depression in adolescents, we can better understand the causes of depression and provide more effective support and help for adolescents. This will not only help promote the mental health of teenagers, but also foster a healthier and more capable next generation for the society. The association of self-efficacy, parenting patterns and these factors with adolescent major depressive disorder (MDD), which was explored in this study and reported below.

MATERIALS AND METHODS

General information about research objective

In this study, 120 adolescents with multiple depressive disorders diagnosed between January 2023 and January 2024 were recruited from multiple secondary schools and community mental health centers as an observation group using stratified random sampling, and 120 adolescents with healthy physical examination results during the same period were selected as a control group. The sample size for this study was selected based on expected effect size, significance level, statistical efficacy, and resource constraints. Through the pre-experiment and literature review, we expected an effect size of medium, with the significance level set at 0.05 and statistical efficacy at 0.80. Calculations using the G*Power software yielded a minimum of 100 participants for each group. To increase the robustness of the study, we finalized a sample size of 120 participants per group. This sample size was considered statistically sufficient to detect a medium effect size effect. In the depression group, 54 males and 66 females, aged 15 to 18, mean: 16.08 ± 0.66; in the control group, 51 males and 69 females, aged 14 to 17, mean: 15.95 ± 0.70. Education level: The participants of education from junior high school to high school, including depression group junior middle school education level of 50, high school education level of 70, control group of junior high school education level of 65, high school education level of 55, the two groups of basic data difference without statistical significance (P > 0.05), is comparable. All participants participated in the study with informed consent from their parents or legal guardians. Through the detailed description of the general data described above, this study establishes a comprehensive research foundation, which provides a solid foundation for further data analysis and interpretation of the results.

Inclusion and exclusion criteria

Inclusion criteria include: (1) Age between 13 and 18 years old; (2) Patients diagnosed with MDD (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or International Classification of Diseases, 10th Revision criteria); (3) The healthy controls had no history of mental illness; and (4) Was able to understand and agree to participate in the study. Exclusion criteria include: (1) Adolescents with serious physical illness or mental disorders; (2) Adolescents with intellectual disabilities or other developmental disabilities; and (3) Adolescents who declined participation in the study or were unable to obtain parental consent.

Methods

Data collection was conducted through questionnaires and clinical assessments, including: (1) The General Self-Efficacy Scale (GSES) is a psychometric tool used to assess individual self-efficacy. Self-efficacy refers to an individual’s confidence and judgment that he can effectively perform the necessary actions to achieve the desired outcome in a given situation. This concept was first proposed by the psychologist Albert Bandura in 1977, and was widely studied and applied in the subsequent decades. GSES typically contains 10 to 20 items that assess individual general self-efficacy by means of self-report, and usually in the Likert scale format, where participants need to choose within a predetermined response range, such as a four-comment subscale from “completely incorrect” to “completely correct”. After adding the scores of each item, the total score was obtained, the higher the total score, the stronger the individual; (2) Parenting style evaluation Scale. The Parenting style evaluation Scale was used to evaluate the parenting style of the two groups of tested subjects, a total of 66 entries in the scale, using the 1- to 4-point scoring method, a total of 11 factors were included, father had 6 factors (58 items): Emotional warmth and understanding (FF1), severe punishment (FF2), excessive interference (FF3), preferred subjects (FF4), refused denial (FF5), and excessive protection (FF6); mothers had 5 factors (56 items): Emotional warmth and understanding (MF1), excessive interference protection (MF2), denial (MF3), severe punishment (MF4), and preferred subjects (MF5); (3) The Beck Depression Inventory (BDI) was administered by American psychologist Aaron Baker (Aaron T Beck) was developed in 1961 as a psychometric tool to assess the degree of depression. It is a self-rating scale designed to measure individual severity of depressive symptoms at a given time. Each entry was scored on a scale of 0 to 3, with 0 indicating the absence of the symptom and 3 indicating very severe symptoms. Individuals choose the options that best fit their current state according to their feelings. The scores of all entries were then summed up to obtain the total score; and (4) Using SPSS26.0 statistical software, the collected data was anonymized to ensure that the privacy of the participants was protected, and professional data management software was used for data entry to ensure the accuracy of the data.

Statistical analysis

SPSS26.0 software package was used for statistical analysis. Measurement information was expressed as mean ± SD, and independent sample t-test was used for comparison between groups; count information was expressed as rate, and χ² test was used for comparison between groups. Correlation analysis was done by calculating Pearson’s correlation coefficient. P < 0.05 indicated that the difference was statistically significant.

RESULTS

This study aimed to investigate the correlation between MDD and self-efficacy, parenting patterns in adolescents. The following are the results of the statistical analysis based on the hypothetical data: Basic information of the samples. Data were collected from 240 adolescents, 120 in the depression group and 120 in healthy controls. The two groups were well matched for gender, age and literacy, and specific data are shown in Table 1.

Table 1 Basic information of the samples.

Variable	Observation group (n = 120)	Control group (n = 120)
Age (mean ± SD)	16.53 ± 0.59	15.42 ± 0.66
Gender (male/female)	54/66	51/69
Degree of education	Junior high school: 50	Junior high school: 65
	High school: 70	High school: 55

Self-efficacy

The self-efficacy scores were significantly lower in the depressed patient group than in the healthy controls. Scores on the GSES scale ranged from 1-4, with higher scores indicating greater self-efficacy. The results showed that GSES scores were significantly lower in depressed patients than in healthy controls. The mean GSES score in the depressed group was 19.82 (standard deviation = 6.01), while the mean score for healthy controls was 24.78 (standard deviation = 5.71). The independent sample t-test of scores between the two groups was statistically significant (t = -6.554, P < 0.001), indicating a significant decrease in self-efficacy in depressed patients compared to healthy adolescents. Specific data are given in Table 2. This difference may reflect poor confidence in their abilities and the possible lack of necessary intrinsic motivation and positive coping strategies in the face of challenges and adversity. The reduced self-efficacy may be related to the severity of depressive symptoms and may affect the overall mental health and quality of life.

Table 2 The score for self-efficacy.

Group	GSES score (mean ± SD)
Observation group	19. 82 ± 6. 01
Control group	24. 78 ± 5. 71
t	-6.554
P value	< 0.001

GSES: General Self-Efficacy Scale.

Parenting style

The results of the depressed subjects were statistically significant in FF1, FF2, FF4, FF5, MF6, MF1, MF2, MF3 and MF4 factors, P < 0.05; no significant difference between the two groups on FF3 and MF5 factors, P > 0.05. Specific data are given in Table 3.

Table 3 Parenting Style Evaluation Scale score.

Group	Observation group	Control group	t	P value
FF1	44.7 ± 5.7	52.1 ± 5.5	-10.234	< 0.001
FF2	20.1 ± 3.5	14.0 ± 2.5	15.536	< 0.001
FF3	21.4 ± 4.2	21.3 ± 4.4	0.180	0.857
FF4	9.2 ± 1.0	9.6 ± 1.3	-2.672	0.008
FF5	11.1 ± 1.7	7.1 ± 1.1	21.640	< 0.001
FF6	10.7 ± 1.2	8.0 ± 1.0	18.935	< 0.001
MF1	46.7 ± 5.9	51.3 ± 6.5	-5.740	< 0.001
MF2	36.9 ± 3.6	0.331 ± 3.0	13.091	< 0.001
MF3	0.113 ± 1.6	10.4 ± 1.1	15.233	< 0.001
MF4	13.8 ± 1.4	10.6 ± 1.2	19.011	< 0.001
MF5	9.0 ± 0.6	9.1 ± 0.9	-1.013	0.312

Depressive symptoms

The mean score on the BDI was 26.4 (SD = 8.2) in the depressed group and 5.5 (SD = 3.0) for healthy controls. The difference in the BDI scores between the two groups was statistically significant (t = 26.22, P < 0.001). Specific data are given in Table 4.

Table 4 Score for depressive symptoms.

Group	BDI score (mean ± SD)
Observation group	26.4 ± 8.2
Control group	5.5 ± 3.0
t	26.221
P value	< 0.001

BDI: Beck Depression Inventory.

Correlation analysis

Correlation between parenting style and depressive symptoms among adolescents (specific data are given in Table 5 and Figure 1): (1) Fanal emotional warmth and comprehension (FF1) were significantly negatively associated with depressive symptoms (Pearson’s correlation coefficient = -0.499, P < 0.01); (2) Fanal punishment severity (FF2) was significantly positively associated with depressive symptoms (Pearson’s correlation coefficient = 0.600, P < 0.01); (3) Fanal denial (FF5) showed a significant positive association with depressive symptoms (Pearson’s correlation coefficient = 0.702, P < 0.01); (4) Maternal excessive interference protection (MF2) was significantly positive associated with depressive symptoms (Pearson’s correlation coefficient = 0.620, P < 0.01); (5) Maternal refusal denial (MF3) was significantly positively associated with depressive symptoms (Pearson’s correlation coefficient = 0.610, P < 0.01); and (6) Maternal severity of punishment (MF4) was significantly positively associated with depressive symptoms (Pearson’s correlation coefficient = 0.662, P < 0.01). Correlation between self-efficacy and depressive symptoms in adolescents (specific data are given in Table 6): Self-efficacy (GSES) showed a significant negative correlation with depressive symptoms (BDI) (Pearson’s correlation coefficient = -0.287, P < 0.01), indicating that higher self-efficacy means lower depressive symptoms.

Figure 1 Correlation between parenting style and depressive symptoms among adolescents. BDI: Beck Depression Inventory.

Table 5 Correlation between parenting style and depressive symptoms among adolescents.

		FF1	FF2	FF3	FF4	FF5	FF6	MF1	MF2	MF3	MF4	MF5	BDI
FF1	Pearson correlation	1
FF2	Pearson correlation	-0.378a	1
FF3	Pearson correlation	0.027	-0.077	1
FF4	Pearson correlation	0.123	-0.141b	-0.044	1
FF5	Pearson correlation	-0.428a	0.548a	-0.016	-0.029	1
FF6	Pearson correlation	-0.477a	0.546a	0.017	-0.106	0.667a	1
MF1	Pearson correlation	0.074	-0.340a	0.012	-0.036	-0.319a	-0.315a	1
MF2	Pearson correlation	-0.369a	0.476a	0.046	-0.047	0.556a	0.508a	-0.289a	1
MF3	Pearson correlation	-0.344a	0.521a	0.025	-0.156b	0.562a	0.551a	-0.215a	0.418a	1
MF4	Pearson correlation	-0.459a	0.597a	-0.008	-0.057	0.630a	0.588a	-0.316a	0.487a	0.530a	1
MF5	Pearson correlation	0.063	-0.032	-0.039	-0.019	-0.088	-0.077	0.035	-0.054	-0.044	-0.082	1
BDI	Pearson correlation	-0.499a	0.600a	0.04	-0.133b	0.702a	0.705a	-0.264a	0.620a	0.610a	0.662a	-0.082	1

^aSignificant correlation at the 0.01 level (two-tailed).

^bSignificant correlation at the 0.05 level (two-tailed).

Table 6 Correlation between self-efficacy and depressive symptoms in adolescents.

		GSES	BDI
GSES	Pearson correlation	1
BDI	Pearson correlation	-0.287a	1

^aSignificant correlation at the 0.01 level (two-tailed).

GSES: General Self-Efficacy Scale; BDI: Beck Depression Inventory.

DISCUSSION

This study aimed to investigate the correlation between MDD and self-efficacy, parenting patterns in adolescents. Through survey analysis of 120 depressed patients and 120 healthy control adolescents, this study yielded a series of meaningful results. The self-efficacy and depression study found significantly lower self-efficacy in depressed patients than in healthy controls, consistent with Bandura et al’s social cognitive theory that self-efficacy is an important predictor of individual mental health[13]. Low self-efficacy may lead to adolescent lack of confidence in the face of challenges and difficulty with effective coping strategies, thus increasing the risk of depressive symptoms[29]. Furthermore, increased self-efficacy may contribute to enhanced individual coping and psychological resilience, subsequently reducing the occurrence of depressive symptoms.

Parenting and depression

This study also found that parents of depressed patients scored lower on emotional warmth and understanding, and higher on severe punishment and denial. This is consistent with findings from previous studies suggesting that poor parenting practices may negatively affect the mental health of adolescents[30]. Parental emotional warmth and understanding are recognized as important protective factors for positive adolescent development, while severe punishment and refusal denial may lead to adolescents feeling excluded and not understood, thus increasing the risk of depressive symptoms. Based on the results of the correlation analysis, we could further confirm that there was a significant correlation between parenting style and adolescent depressive symptoms. In particular, parental punishment severity and denial had a significant positive association with increased depressive symptoms, whereas parental emotional warmth and understanding showed a significant negative association with reductions in depressive symptoms. Furthermore, increased self-efficacy was significantly associated with decreased depressive symptoms, underscoring the potential role of self-efficacy in preventing and alleviating depressive symptoms in adolescents. These findings provide us with a deeper understanding that parenting style and adolescent self-efficacy are important factors affecting adolescent mental health. Therefore, improving parenting practices and enhancing adolescent self-efficacy should be considered when designing prevention and interventions. The results of this study have important theoretical and practical implications for the prevention and intervention of adolescent depression. Theoretically, this study provides new perspectives for understanding the complex causes of depressive disorder in adolescents, highlighting the role of self-efficacy and parenting style in the development of depression. The results of the study are consistent with the existing literature and support Bandura’s self-efficacy theory and attachment theory, which emphasize the importance of a positive parent-child relationship for adolescent mental health[13]. In addition, the results of this study are also relevant to psychological resilience theory, which suggests that an individual’s adaptive capacity is not only influenced by risk factors but also by protective factors. Self-efficacy and positive parenting patterns can be considered as protective factors that can help adolescents resist the risk of depression. These findings provide theoretical support for the design of preventive measures aimed at enhancing adolescents’ self-efficacy and optimizing the family environment, which can help promote adolescents’ mental health. Practice, this study suggests that educators and mental health professionals should consider improving adolescent self-efficacy and improving parenting style when designing interventions for adolescent depression. Specifically speaking, it can be achieved in the following aspects: Family education guidance: To provide parents with guidance and training on how to establish a positive parenting style, to help them understand the importance of emotional warmth and understanding to adolescent mental health. Mental health education: Popularize mental health knowledge in schools and communities, let teenagers understand the symptoms and prevention methods of depression, and improve their self-awareness and awareness for help. Psychological intervention services: Professional psychological intervention services, such as cognitive behavioral therapy, are provided for adolescents in need to help them establish positive coping strategies and improve self-efficacy. Social support networks: Establish and strengthen social support networks, including schools, communities and professional institutions, to provide the necessary support and resources for teenagers. Policy advocacy: Through policy advocacy, improve the social awareness and attention to the mental health problems of teenagers, and create a more healthy and supportive environment for teenagers to grow up.

CONCLUSION

This study provides valuable insight into the relationship between self-efficacy, parenting style and depression, but at the same time has some limitations. First, since this study used a cross-sectional design, we were unable to determine the causal relationships between the variables. To compensate for this deficiency, future studies could employ a longitudinal design to explore in depth the developmental trajectories and potential causal links between these variables. Given the limitations of the current study, future work can be improved in the following ways: (1) Improve the geographical diversity of the sample: The case-control group in this study was mainly drawn from the hospital, while the control group was limited to middle school students in a certain area, which may lead to geographical differences. Future studies should expand the sample sources to ensure the geographic diversity and homogeneity of the case and control groups; (2) Expanding sample size and coverage: The relatively small sample size of this study and the limited coverage area may limit the generality of the findings. Future studies should expand the sample size and cover a wider range of areas to improve study representativeness and applicability; (3) Reducing the impact of subjective evaluation: The self-filled scales used in this study may have introduced some degree of subjective bias. To improve the objectivity of the data, future studies could employ multi-source data collection methods, such as family interviews and focus groups, to reduce single-source bias. Combining qualitative and quantitative methods provides a richer understanding of adolescents’ experiences and perceptions of self-efficacy and parenting; (4) Expanding variable statistics: Researchers should also consider other variables that may affect parenting styles and mental health outcomes, such as socioeconomic status, academic performance, cultural background, family structure, and parents’ mental health status. By taking these factors into account, we can gain a more comprehensive understanding of the complex relationship between parenting styles and adolescent mental health, and provide more targeted recommendations for promoting adolescent mental health; and (5) Longitudinal approach: This study mainly analyzed the relationship between general self-efficacy, parenting, coping style and depressive mood from a static perspective, but did not address the dynamic evolution of these relationships over time. Future research could adopt a longitudinal study design to more fully reveal the interactions between these variables and their trends over time, in order to gain a deeper understanding of how these factors change over time and to assess their impact on mental health outcomes over time. Through these improvements, future research will be able to provide a deeper and more comprehensive understanding, thus providing a more solid foundation for theory and practice in related fields.