Bridging parental rejection and overprotection: implications of their co-occurrence for family-based interventions in children with attention deficit hyperactivity disorder

Introduction

Attention deficit hyperactivity disorder (ADHD) (1) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Symptoms typically emerge before age 12 years and may persist into adulthood. These symptoms cause difficulties in social interactions, academics, and occupational performance across various contexts Globally, ADHD prevalence ranges from 5.9% to 7.1%, with rates in China estimated at approximately 6.26% among school-aged children. The etiology of ADHD is multifactorial, involving complex interactions between genetic, neurobiological, and environmental factors. Among these environmental influences (2-4). One of the risk factors associated with ADHD in children pertains to the parenting style exhibited by careers who demonstrate suboptimal performance in their parental roles, as well as the absence of positive parenting practices (5,6).

Parenting a child with ADHD presents unique challenges, and parents of children with ADHD may develop distinct parenting approaches compared to parents of typically developing children. Children with ADHD often have difficulty with impulse control, hyperactivity, and attention, which can affect their behavior and academic performance. This can lead to higher levels of stress and frustration for parents, who may struggle to find effective ways to manage their child’s behavior (7). As a result, parents of children with ADHD often display suboptimal parenting practices, including excessive control and punitive responses to externalizing behaviors

Parenting styles (authoritative, authoritarian, permissive, and neglectful) vary in warmth and control levels, influencing children’s socio-emotional and behavioral development. The authoritative style, combining high warmth with appropriate control, is considered most effective for child development. However, the stress and challenges associated with parenting children with ADHD may lead parents to adopt less optimal parenting approaches (8).

Among the various parenting approaches observed in families of children with ADHD, overprotective parenting has received particular attention in recent research. Research indicates that parents of children with ADHD may show higher levels of overprotectiveness compared to other parenting approaches. This involves excessive involvement, restricting autonomy, monitoring activities, decision-making for the child, and limiting exposure to challenges. While both parents may exhibit these behaviors, mothers typically show higher levels of overprotectiveness than fathers, possibly due to their primary caregiving role and increased time with the child. This overprotective parenting often results in limited social interactions for the children (9,10). Recent studies have further demonstrated that overprotective parenting may be both a consequence of and contributor to ongoing ADHD-related difficulties (11).

Understanding overprotective parenting in Chinese families requires consideration of cultural context. Chinese parental overprotection may reflect Confucian “guan” a cultural concept emphasizing parental duty to morally guide children, which is distinct from Western 'helicopter parenting (12). This cultural framework suggests that what may appear as overprotection in Western contexts might reflect traditional Chinese values of parental responsibility and care. The Confucian concept of guan involves active guidance and protection as expressions of parental love and duty, rather than simply restrictive control. This cultural framework makes it essential to understand overprotection within specific cultural contexts when studying Chinese families.

Despite growing interest in parenting styles among families of children with ADHD, limited research has examined the relationships between different parenting dimensions within the same families. Specifically, it remains unclear whether overprotective, rejecting, and emotionally warm parenting behaviors co-occur or represent independent dimensions in parents of children with ADHD. Understanding these relationships is crucial for developing targeted parenting interventions.

Therefore, this study aims to examine the associations between different parenting style dimensions (rejection, overprotection, and emotional warmth) in Chinese parents of children with ADHD. The primary objectives are to: (I) investigate correlations between these parenting dimensions within the same families; and (II) compare these associations between mothers and fathers. By focusing on within-group associations rather than between-group comparisons, this study seeks to provide insights into the complex relationships between different parenting approaches in families managing ADHD-related challenges. We present this article in accordance with the STROBE reporting checklist (available at https://tp.amegroups.com/article/view/10.21037/tp-2025-462/rc).

Methods

Participants

Inclusion and exclusion criteria

Children aged 7–9 years with confirmed ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria were included (13,14). Inclusion criteria required: (I) primary ADHD diagnosis by qualified clinician (13,14); (II) absence of comorbid intellectual disability or autism spectrum disorder; (III) stable medication regimen for ≥4 weeks if applicable; (IV) both parents available for assessment; and (V) written parental consent. Exclusion criteria included: (I) significant medical conditions affecting behavior; (II) current psychiatric hospitalization; (III) non-Chinese speaking families; and (IV) incomplete questionnaire data.

The final sample comprised 31 families with ADHD-diagnosed children (51.6% male, 48.4% female) aged 7–9 years. All participants were recruited from pediatric and behavioral outpatient clinic at Hangzhou First People’s Hospital reflecting the corresponding author’s prior affiliation. From 59 families initially approached, 31 met inclusion criteria and provided consent, while some families did not (response rate: 52.5%).

Study tools and procedures

Data collection procedures

Data collection occurred at pediatric outpatient. Parents completed structured questionnaires assessing demographic information (age, gender, family income, parental education level), child characteristics (ADHD symptom severity, medication status), and relevant medical history (comorbid conditions, treatment history).

ADHD assessment

All ADHD diagnoses were confirmed using DSM-5 (15) criteria by qualified clinicians (pediatricians and child psychologists). ADHD symptom severity was assessed using the DSM-5 ADHD Children’s Behavior Scale, an 18-item instrument with two dimensions (inattention and hyperactivity-impulsivity). Items are scored on a 4-point scale, with total scores ranging from 0.00–1.00 (higher scores indicating greater symptom severity). Route map of study is given in Figure 1.

Figure 1 Technical route map of the study. ADHD, attention deficit hyperactivity disorder; DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; EMBU, Egna Minnen Beträffande Uppfostran.

Egna Minnen Beträffande Uppfostran (EMBU) (parenting style assessment)

Scale description

The Short-EMBU-C (S-EMBU-C) is a 23-item abbreviated version of the EMBU-C questionnaire originally developed by Arrindell et al. (16) and validated in Chinese populations by Jiang et al. (17). The instrument assesses perceived parenting behaviors across three dimensions: rejection (8 items; e.g., “criticized me in front of others”), overprotection (7 items after exclusion; e.g., “was overprotective of me”), and emotional warmth (8 items; e.g., “praised me for good behavior”).

Scoring and interpretation

Items are rated on a 4-point Likert scale (1= never, 2= sometimes, 3= often, 4= always). Dimension scores are calculated as mean item ratings, with higher scores indicating greater presence of that parenting behavior. The scale assesses maternal and paternal behaviors separately.

Age adaptation

While the original EMBU was designed for adolescents and adults recalling childhood experiences, the S-EMBU-C (18) has been successfully adapted for direct administration to children. Research assistants provided age-appropriate instructions and examples, using simplified language and visual aids when necessary. Children completed questionnaires with assistance available for reading difficulties.

Psychometric properties

The Chinese S-EMBU-C demonstrates adequate reliability and validity in pediatric samples, with Cronbach’s α coefficients of 0.78 (rejection), 0.73 (overprotection), and 0.81 (emotional warmth) reported in previous studies with similar age groups (19).

Item modification

Item 10 from the overprotection subscale (“worried when I was away”) was excluded as it primarily reflects parental anxiety rather than overprotective behavior, making it less relevant for assessing parenting style in our target population.

Ethical considerations

The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Ethical Committee of Hangzhou First People’s Hospital {Medical Ethics Review [2022] No. 071-01}. Written informed consent was obtained from all participants’ parents or legal guardians before data collection.

Statistical analysis

All statistical analyses were conducted with SPSS version 20.0. An a-priori power analysis showed that n=31 provided >80% power to detect a large effect (f²=0.33) for the primary multiple-regression analysis at α =0.05 (Figure S1). Data are presented as mean ± standard deviation (SD) or as frequencies and percentages (Table 1). Descriptive statistics summarised demographic variables and parenting dimensions Mean item scores for fathers, mothers, and the total sample were compared using paired-sample t-tests (Table 2). Differences in frequency distributions of EMBU response categories between fathers and mothers were examined using Chi-squared tests (Table 3). Inter-relationships among parenting constructs were examined with Pearson correlations for the total sample and separately for mothers and fathers (Tables 4-6, Figures 2-4). Moderation analysis tested whether parental education influenced the association between over-protection and rejection (Table S1). Multicollinearity diagnostics confirmed no concerning correlations among predictors (Table S2). Hierarchical regression assessed the predictive contribution of parenting dimensions to ADHD symptom severity after controlling for demographic factors (Table S3). Key findings were visualised with heat-maps of correlations and scatter-plots with regression lines (Figures S2,S3). Statistical significance was set at P<0.05 for all tests.

Figure 2 Correlation between groups of total population.

Figure 3 Correlation between groups of fathers.

Figure 4 Correlation between groups of mothers.

Results

Participant demographics and family characteristics

This study included 31 families with children who were clinically diagnosed with ADHD. Educational stratification revealed the following distribution: secondary/vocational education (41.9%), junior secondary education (25.8%), primary education or below (19.4%), and tertiary education (12.9%). Familial ADHD history among extended relatives was documented in 22.6% of cases (Table 1).

Comprehensive demographic data encompassing parental personality profiles, socioeconomic indicators, marital quality assessments, disciplinary approaches, and parent-child interaction duration were systematically collected via validated questionnaires administered during initial clinical consultations.

Parental caregiving approaches and early care patterns

The main discipline style of the family was predominantly the Mixed type, accounting for 83.9% (n=26) of the cases, while the Dominant type was observed in 16.1% (n=5) of the families. The Doting type, Despotic type, and Laissez-faire type were not observed in this sample.

Early childhood caregiving patterns revealed that grandparental care predominated during the pre-three-year period (41.9%), followed by professional caregivers (22.6%), fathers (19.4%), and mothers (16.1%). This configuration reflects prevalent intergenerational caregiving structures within urban Chinese family systems (Table 1).

EMBU parenting construct distributions

The EMBU assessment yielded three primary parenting dimensions: rejection (characterized by criticism and hostility), emotional warmth (encompassing affection and supportiveness), and overprotection (reflecting excessive control and anxious concern). Cross-sectional analysis demonstrated moderate expression levels across all constructs.

EMBU parenting construct distributions

The EMBU assessed three parenting dimensions rejection, emotional warmth, and overprotection. Item-level descriptive statistics are presented in Table 2. Rejection items had total means ranging from 1.683±1.171 (bitter or angry) to 2.666±1.244 (scapegoat), emotional warmth items from 2.183±0.965 (stimulate) to 2.966±0.956 (like), and overprotection items from 1.650±1.005 (put definite limits) to 2.600±1.196 (account to parents).

Mothers generally displayed higher emotional warmth than fathers for example, praise (mother =2.633±0.999, father =2.200±0.886), like (3.166±0.874 vs. 2.766±1.006), and warm feelings (2.466±1.008 vs. 2.166±1.053). Rejection items were similar across parents, such as bitter or angry (1.766±1.194 vs. 1.600±1.162) and criticize (1.833±1.234 vs. 1.633±1.188). Overprotection items also showed close father–mother similarity, for instance, worry (2.133±1.065 for both) and account to parents (2.433±1.135 vs. 2.766±1.250). Parent-specific frequency distributions are reported in Table 3.

Inter-dimensional correlational architecture

Rejection and overprotection demonstrated robust positive intercorrelation across the complete sample (r=0.811, P<0.001), constituting a large effect magnitude per Cohen’s criteria. This relationship indicates that heightened parental criticism systematically co-occurs with excessive protective behaviors. A heat-map displaying all pairwise correlations, with non-significant cells shaded white, is provided in Figure S2.

Emotional warmth exhibited negligible associations with rejection (r=−0.024, P=0.85) and overprotection (r=−0.116, P=0.38), both relationships lacking statistical significance. These findings suggest emotional warmth functions as an independent parenting dimension within this clinical population (Table 4, Figure 2).

Parent-specific analyses corroborated this pattern. Paternal data revealed identical strong rejection-overprotection coupling (r=0.800, P<0.001), while maternal correlations demonstrated even stronger magnitude (r=0.822, P<0.001). Emotional warmth maintained weak, non-significant associations across both parental groups (Tables 5,6, Figures 3,4).

Educational moderation of parenting relationships

Hierarchical moderation analyses unveiled differential parenting patterns contingent upon educational attainment. Tertiary-educated fathers exhibited an inverse relationship wherein protective behaviors negatively predicted rejecting responses (β =−0.32, P=0.04), suggesting adaptive parenting integration. Conversely, non-tertiary-educated fathers demonstrated maladaptive coupling where protection and rejection co-escalated (β =0.45, P=0.01).

Maternal patterns revealed that exclusively non-tertiary-educated mothers exhibited problematic rejection-overprotection synergy (β =0.38, P=0.03), while tertiary-educated mothers showed non-significant interdimensional relationships (β =0.11, P=0.27), indicating dimensional independence (Table S2).

Statistical assumption verification

Multicollinearity diagnostics via variance inflation factor (VIF) analysis confirmed acceptable intercorrelation levels across all predictor variables. Maximum VIF values remained substantially below conventional thresholds (maternal rejection: 3.7; maternal overprotection: 2.3; paternal rejection: 2.5; paternal overprotection: 1.8; income: 1.2; education: 1.5; threshold =5.0), validating analytical integrity (Table S1). The achieved sample size (n=31) exceeds the 80% power threshold for detecting a large effect (f²=0.33) in the primary multiple-regression model (Figure S1).

Hierarchical prediction of ADHD symptomatology

Sequential regression modeling examined ADHD symptom severity predictors through incremental variable integration. Initial demographic model incorporating socioeconomic indicators accounted for 12% of symptom variance (income: β =−0.18, P=0.08; education: β =−0.22, P=0.04).

Enhanced parenting model substantially augmented predictive capacity, yielding 26% additional variance explanation (total R²=0.38). Maternal constructs emerged as primary predictors: maternal rejection (β =0.35, P<0.001) and maternal overprotection (β =0.29, P=0.01) both significantly predicted elevated symptom severity. The scatter-plot with regression line illustrating this association is shown in Figure S3. Paternal parenting dimensions demonstrated non-significant predictive relationships, indicating maternal primacy in symptom manifestation (Table S3).

Discussion

This study investigated the impact of overprotective parenting on children with ADHD, focusing on parental roles, education, and family dynamics. Our findings reveal significant associations between overprotective parenting and ADHD symptoms, with notable differences between maternal and paternal influences.

The present investigation reveals a robust positive correlation between parental rejection and overprotection among Chinese mothers and fathers of children with ADHD. These findings suggest that seemingly distinct parenting behaviors may constitute a unified, maladaptive response to the challenges inherent in raising children with neurodevelopmental disorders (9,20). The observed strong correlation (r=0.811) indicates that escalating levels of one negative parenting dimension correspond with increases in the other, potentially establishing a cyclical pattern of deteriorating parent-child interactions.

The interconnection between parental rejection and overprotection warrants particular attention. While overprotective behaviors may stem from parental intentions to shield children from potential harm or academic failure, children frequently perceive such actions as intrusive and controlling, a perception linked to increased psychological control and subsequent depressive symptoms (21) as well as concurrent internalizing problems. When combined with rejecting behaviors characterized by hostility and criticism (22), children experience a particularly detrimental parenting environment. Recent evidence demonstrates that both overprotection and rejection are associated with diminished distress tolerance and elevated psychological distress in pediatric populations. These findings extend existing knowledge by revealing that these parenting dimensions are not merely independently harmful, but are fundamentally interconnected within the ADHD context.

Independence of emotional warmth

In contrast to the strong association between rejection and overprotection, emotional warmth emerged as an independent parenting dimension. This pattern suggests that parents may continue to express emotional warmth despite exhibiting high levels of rejection and overprotection. These findings align with previous research that identifies emotional warmth as a protective factor capable of buffering the adverse effects of other negative parenting behaviors (23). The independence of emotional warmth as a distinct dimension indicates that interventions focused on enhancing parental warmth may prove beneficial, even in the absence of immediate reductions in rejection or overprotection.

Maternal primacy in ADHD symptom prediction

Results demonstrate the pivotal role of maternal parenting in predicting ADHD symptom severity. Both maternal rejection and overprotection significantly predicted elevated ADHD symptoms, while paternal parenting dimensions showed no significant associations. These patterns align with established research emphasizing maternal primacy in ADHD symptom development and maintenance (24). Such findings may reflect mothers’ predominant caregiving roles, resulting in greater temporal exposure and developmental influence. Additionally, mothers may experience heightened stress when parenting children with ADHD, potentially leading to more pronounced negative parenting behaviors due to their increased involvement in managing ADHD-related challenges.

Cultural context and implications

Interpretation of these results requires consideration of Chinese cultural frameworks. The Confucian concept of “guan”, which emphasizes parental responsibility and moral guidance, may influence how overprotective behaviors are conceptualized and implemented within Chinese families (25). Behaviors perceived as overprotective in Western contexts may represent expressions of parental love and duty within Confucian value systems. However, when such overprotection is combined with rejection, negative outcomes emerge. These patterns underscore the critical importance of incorporating cultural factors when evaluating parenting styles and their effects on children with ADHD

Clinical implications of rejection-overprotection clustering

The clustering of parental rejection and overprotection suggests that these negative parenting dimensions may co-occur and mutually reinforce each other, increasing the risk of persistent ADHD symptoms across development. Therefore, interventions targeting both emotional rejection and overprotective control simultaneously could yield more sustainable behavioral and emotional improvements in children with ADHD (22,26).

Limitations

Several methodological constraints warrant acknowledgment. Data collection during 2022 coronavirus disease 2019 (COVID-19) pandemic waves resulted in a restricted sample size (n=31) due to public health restrictions and patient reluctance. The questionnaire-based methodology utilizing S-EMBU instruments may be vulnerable to social desirability bias and cannot comprehensively capture parent-child interaction complexities. The cross-sectional design prohibits causal inferences regarding relationships between parenting behaviors and ADHD symptoms. Additionally, recruitment from a single Hangzhou hospital constrains generalizability to other Chinese regions. The sample included only families seeking clinical help, which may represent more severe ADHD cases and higher family stress than typical families. This limits how well the findings apply to all children with ADHD. Additionally, the study did not examine whether factors like child age, gender, or ADHD type might change the relationships between parenting and symptoms.

Future directions

These findings highlight several critical research directions. Longitudinal studies with larger sample sizes are essential to establish causal relationships between parenting behaviors and ADHD symptoms and identify optimal intervention timing. Future research should employ multi-method approaches combining surveys, behavioral observations, and physiological measures to provide comprehensive assessment while overcoming self-report limitations. Machine learning algorithms could be developed to predict ADHD symptom severity based on parenting patterns, enabling early identification of at-risk children and personalized intervention strategies. Advanced statistical modeling techniques, including structural equation modeling and network analysis, would better capture the complex interactions between multiple parenting dimensions. Developing and evaluating parent training programs represents a priority, with interventions promoting warmth, reducing harsh discipline, and fostering balanced parenting approaches. Investigation of moderating factors including child age, gender, and ADHD subtype could inform personalized interventions and improve treatment outcomes.

Conclusions

Parental rejection and overprotection tend to co-occur, forming a maladaptive pattern that may intensify behavioral difficulties in children with ADHD. Emotional warmth, however, remains an independent and potentially protective factor that can mitigate the negative effects of these parenting behaviors. Maternal influences appear particularly significant, with higher levels of rejection and overprotection associated with greater symptom severity in children. These findings emphasize the importance of promoting balanced, supportive, and emotionally responsive parenting approaches. Strengthening positive parent-child interactions and reducing controlling or rejecting behaviors may play a vital role in improving emotional regulation, social development, and overall well-being in children with ADHD.

Acknowledgments

We would like to thank Professor Chunming Jiang of the Pediatrics Department for his guidance on this innovative topic, and we are grateful to all parents and children whose participation made this study possible.

Footnote

Reporting Checklist: The authors have completed the STROBE reporting checklist. Available at https://tp.amegroups.com/article/view/10.21037/tp-2025-462/rc

Data Sharing Statement: Available at https://tp.amegroups.com/article/view/10.21037/tp-2025-462/dss

Peer Review File: Available at https://tp.amegroups.com/article/view/10.21037/tp-2025-462/prf

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-2025-462/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Ethical Committee of Hangzhou First People’s Hospital {Medical Ethics Review [2022] No. 071-01}. Written informed consent was obtained from all participants’ parents or legal guardians before data collection.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Sim F, Dalgarno L, McIntosh E, et al. Families with neurodevelopmental diagnoses are not 'Hard to Reach': Findings from a feasibility trial comparing parenting programmes for parents of children with ADHD. PLoS One 2025;20:e0323959. [Crossref] [PubMed]
2. First MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis 2013;201:727-9.
3. Agha SS, Zammit S, Thapar A, et al. Are parental ADHD problems associated with a more severe clinical presentation and greater family adversity in children with ADHD? Eur Child Adolesc Psychiatry 2013;22:369-77. [Crossref] [PubMed]
4. Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis. BMC Psychiatry 2017;17:32. [Crossref] [PubMed]
5. Teixeira MC, Marino RL, Carreiro LR. Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder. ScientificWorldJournal 2015;2015:683062. [Crossref] [PubMed]
6. Pimentel MJ, Vieira-Santos S, Santos V, et al. Mothers of children with attention deficit/hyperactivity disorder: relationship among parenting stress, parental practices and child behaviour. Atten Defic Hyperact Disord 2011;3:61-8. [Crossref] [PubMed]
7. Setyanisa AR, Setiawati Y, Irwanto I, et al. Relationship between Parenting Style and Risk of Attention Deficit Hyperactivity Disorder in Elementary School Children. Malays J Med Sci 2022;29:152-9. [Crossref] [PubMed]
8. Karbalaei Sabagh A, Khademi M, Noorbakhsh S, et al. Adult Attention Deficit Hyperactivity Disorder and Parenting Styles. Indian J Pediatr 2016;83:254-7. [Crossref] [PubMed]
9. Meyer A, Kegley M, Klein DN. Overprotective Parenting Mediates the Relationship Between Early Childhood ADHD and Anxiety Symptoms: Evidence From a Cross-Sectional and Longitudinal Study. J Atten Disord 2022;26:319-27. [Crossref] [PubMed]
10. Tarver J, Daley D, Sayal K. Beyond symptom control for attention-deficit hyperactivity disorder (ADHD): what can parents do to improve outcomes? Child Care Health Dev 2015;41:1-14. [Crossref] [PubMed]
11. Cueli M, Martín N, Cañamero LM, et al. The Impact of Children's and Parents' Perceptions of Parenting Styles on Attention, Hyperactivity, Anxiety, and Emotional Regulation. Children (Basel) 2024;11:313. [Crossref] [PubMed]
12. Chao RK. Beyond parental control and authoritarian parenting style: understanding Chinese parenting through the cultural notion of training. Child Dev 1994;65:1111-9. [Crossref] [PubMed]
13. Cabral MDI, Liu S, Soares N. Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth. Transl Pediatr 2020;9:S104-13. [Crossref] [PubMed]
14. Jerome D, Jerome L. Approach to diagnosis and management of childhood attention deficit hyperactivity disorder. Can Fam Physician 2020;66:732-6.
15. Díaz-Moreno E, Heredia-Jimenez J, Escabias M. Beyond DSM subtypes: Neuropsychological evidence against functional distinctions in childhood ADHD. Appl Neuropsychol Child 2025; Epub ahead of print. [Crossref]
16. Arrindell WA, Sanavio E, Aguilar G, et al. The development of a short form of the EMBU: Its appraisal with students in Greece, Guatemala, Hungary and Italy. Personality and individual Differences 1999;27:613-28.
17. Jiang J, Lu Z, Jiang BJ, et al. Revision of the short-form Egna Minnen av Barndoms Uppfostran for Chinese. Psychological Development and Education 2010;26:94-9.
18. Yang L, Song A, Wu Y, et al. Impact of parenting style disparities on mental health of medical college students: an analysis of mediating effects of positive psychological qualities. Front Public Health 2025;13:1584232. [Crossref] [PubMed]
19. Wang F, Wu Y, Sun X, et al. Reliability and validity of the Chinese version of a short form of the family health scale. BMC Prim Care 2022;23:108. [Crossref] [PubMed]
20. Brinksma DM, Hoekstra PJ, de Bildt A, et al. Parental rejection in early adolescence predicts a persistent ADHD symptom trajectory across adolescence. Eur Child Adolesc Psychiatry 2023;32:139-53. [Crossref] [PubMed]
21. Huang S. The relationship between parental overprotection and student depression: The chain mediation role of psychological control and well-being. PLoS One 2025;20:e0328498. [Crossref] [PubMed]
22. Sofrona E, Giannakopoulos G. The Impact of Parental Depressive, Anxiety, and Stress Symptoms on Adolescents' Mental Health and Quality of Life: The Moderating Role of Parental Rejection. Children (Basel) 2024;11:1361. [Crossref] [PubMed]
23. Patel P, Behl J, Karim T, et al. Parenting Styles and Attention Deficit Hyperactivity Disorder in the South Asian Population: A Narrative Review. Cureus 2024;16:e74967. [Crossref] [PubMed]
24. Si Y, Ma JLC, Zhang J. Factors influencing parenting stress among Chinese families of children with attention-deficit/hyperactivity disorder. Children and Youth Services Review 2020;116:105148.
25. Lu T, Li L, Tang Y, et al. ADHD and family life: A cross-sectional study of ADHD prevalence among pupils in China and factors associated with parental depression. PLoS One 2024;19:e0281226. [Crossref] [PubMed]
26. Ankori G, Solan M, Plishty S, et al. The Role of Parental Qualities in Supporting Children with ADHD. Children (Basel) 2025;12:845. [Crossref] [PubMed]