Family Cohesion and Emotional–Behavioral Problems in Pakistani Young Children: A Moderating Role of Interpersonal Skills

Abstract

This study investigates the moderating role of interpersonal skills in the relationship between family cohesion and emotional–behavioral problems (EBPs) in a sample of 1,452 (boys = 46% ; girls = 54%) adolescents, between the ages of 12 and 19 years (M = 15.11, SD = 1.33) was selected through multistage sampling technique from Lahore, Islamabad, and Rawalpindi (urbanized cities of Pakistan). Interpersonal Skills Scale (IPSS), Family Cohesion Scale (FCS), and School Children Problems Scale (SCPS) were used to assess the interpersonal skills, family cohesion, and EBPs, respectively. Results suggested that interpersonal skills significantly moderated the relationship between family cohesion and EBPs. Results of the study are discussed by considering the manifestation and expression of interpersonal skills, family cohesion, and EBPs in adolescents of collectivistic cultures.

Keywords

interpersonal skills family cohesion emotional–behavioral problems adolescents

Introduction

Adolescence period is marked by numerous challenges and pressures including changing physical growth, identity formation, high parental and teachers’ expectations, and building new relationships (Danneel et al., 2020; Marcone et al., 2021; Qu et al., 2020) which put the adolescents at a greater risk for developing numerous emotional–behavioral problems (EBPs) (Saleem et al., 2019; Zahra & Saleem, 2021a). EBPs in adolescents are usually known as any emotional and behavioral response that is different from cultural norms and values (Saleem, 2011). Researchers explored that these EBPs in adolescents are linked with several negative outcomes like high school dropout rate, poor academic performance, social incompetence, low self-esteem, loneliness, substance use, physical illness, and lower level of well-being and quality of life (Kumar, 2019; Olivier et al., 2020; Selamu & Singhe, 2018; Sutherland, 2018). Epidemiological studies also identified that there is an increase in the prevalence of EBPs in adolescents and about 15% to 66% of adolescents are experiencing severe levels of EBPs nowadays (Hassanzadeh et al., 2019; Man & Cao, 2020; Paul & Khan, 2019). Therefore, considering the adverse consequences and increased rate of EBPs, it is necessary to explore the buffering factors of EBPs in adolescents.

Literature identified numerous buffering factors of EBPs in adolescents. One of the most prominent buffering factors of EBPs is family cohesion which is characterized by emotional bonding among family members (Lyell et al., 2020; Noh et al., 2020). Family is the fundamental institute that greatly influences the psychosocial well-being of children and adolescents (Baudat et al., 2020). Stable and healthy familial relations are strongest determinants of healthy psychosocial functioning (Harris et al., 2020; Loffe et al., 2020). Family provides support and connectedness during difficult and stressful circumstances, hence playing a significant role in lowering the EBPs of children and adolescents (Zahra & Saleem, 2021a). Piece of research evidences identified that having a higher level of cohesion with family is associated with numerous productive outcomes like academic achievement, social competence, interpersonal skills, self-confidence, and psychosocial well-being (Chang et al., 2020; Harris et al., 2020; McGinley & Evans, 2020; Silva et al., 2020).

Another buffering factor against EBPs is social and interpersonal skills that facilitate and maintain the social interaction (Dykstra et al., 2020). During adolescence, numerous social changes take place and adolescents form new relationships with friends and peers that influence the growth and development of children and adolescents (Jiang et al., 2020). Successful development of social and interpersonal skills leads adolescents toward productive consequences like well-being, quality of life, and healthier psychosocial functioning (Li et al., 2020; Malaquias et al., 2015; Pickering et al., 2020; Son & Padilla-Walker, 2020). Furthermore, literature also identified that the association between family cohesion and EBPs is also greatly determined and influenced by the interpersonal skills (McGinley & Evans, 2020; Saleem et al., 2019). Family cohesion and interpersonal skills both interact with each other to determine the level of EBPs in adolescents and children (Marcone et al., 2021). Having a higher level of interpersonal skills strengthens the relationship between family cohesion and EBPs, hence moderating this association.

Pakistan is a collectivistic society in which obedience, conformity, familial relations, social cohesion, group harmony, and social values are preferred over individual goals and values (Zahra et al., 2020). Relationships between family members in these kinds of collectivistic cultures are also closer and more dependent on each other than in individualistic cultures (Dwairy, 2010; Zahra & Saleem, 2021b). Harmonious familial relationships greatly influence the psychosocial growth and development of children and adolescents. Furthermore, in these kinds of cultures, social relationships are grounded on social support, interdependence, group conformity, and a sense of belongingness (Nadeem et al., 2018; Zahra et al., 2020). Additionally, in Pakistan, the childhood period is lengthy and children have to remain under the supervision of parents and their major life decisions are made by their parents. This parental dependency inhibits them to interact independently until they start schooling (Wu & Keysar, 2007). However, adolescents are socially skilled as their interpersonal and social demands and expectations have altered drastically with varied gender role identification (Nadeem et al., 2017; Saleem et al., 2014). Consequently, adolescence is the developmental phase where individuals acquire social competence and skills that provide a secure base for future social and interpersonal relationships and influence their psychosocial functioning (Erikson, 1968). Therefore, considering the cultural norms and values, it is important to explore the role of familial and social factors in psychosocial functioning of children and adolescents. Therefore, the current study aimed to explore the association between family cohesion, interpersonal skills, and EBPs. Further, this research also aimed to identify the moderating role of interpersonal skills in the relationship between family cohesion and EBPs in Pakistani adolescents.

Method

Participants

A sample of 1,452 adolescents (boys = 46%; girls = 54%), between the ages of 12 and 19 years (M = 15.12; SD = 1.33) was recruited from 19 mainstream government schools of Lahore (8 schools), Rawalpindi (5 schools), and Islamabad (5 schools). There are three parallel systems of education in Pakistan government schools, private schools, and madrassa system (for religious education). Government-run schools were selected for the existing research to maintain the homogeneity in sample. Participants were recruited from 8th (34%), 9th (34%), and 10th (32%). Participants having both parents living with siblings were included in the study. Only children and single-parent children were excluded from this study. Most of the participants (62%) belonged to the nuclear family system.

Measures

Family Cohesion Scale (FCS)

Family cohesion of the participants was measured using the FCS (Zahra & Saleem, 2021) consisting of 51 items having a 4-point Likert rating scale of 0 (never), 1(rarely), 2(to some extent), and 3(very much). The scale consisted of four sub-scales, namely mutual support, sharing, parental involvement, and emotional bonding. Scores of FCS ranged between 0 and 153 with a high score demonstrating greater family cohesion. Cronbach's alpha of the FCS for current research was .91 depicting good internal consistency.

Interpersonal Skills Scale (IPSS)

Interpersonal skills were assessed using the IPSS (Zahra et al., 2020) consisting of 43 items with a 5-point Likert rating scale “0 (not at all), 1(rarely), 2(to some extent), 3(very much), and 4(always)”. Scores of IPSS ranged from 0 to 172 and greater scores indicating greater level of interpersonal skills. Cronbach’s alpha for the IPSS for existing study was .76 suggesting good internal consistency of IPSS.

School Children Problem Scale (SCPS)

The EBPs of the participants were assessed through the SCPS (Saleem & Mahmood, 2011) consisting of 88 items on a 4-point Likert rating scale “0 (never), 1 (rarely), 2 (sometimes) and 3 (often)”. The scale has six factors, namely Anxiousness, Feelings of Rejection, Withdrawal, Academic Problems, Somatic Problems, and Aggression. Scores of EBPs ranged from 0 to 267 with a high score indicating inclined level of EBPs. Cronbach's alpha of the SCPS for the current study was .96 demonstrating that the scale has good internal consistency.

Procedure

First, an official permission from Institutional Review Board (IRB) was gained. After that data were collected from mainstream government schools in Lahore, Rawalpindi, and Islamabad. Initially, 21 schools were personally visited by the researcher. Among them, 19 schools (10 boys and 9 girls) showed their willingness to be part of this study. A brief explanation of the aims and objectives of the existing study was also given to the school authorities and they were also assured about the privacy and confidentiality of the info taken from the participants. After permission from school authorities was gained, researcher visited the classrooms to get data from the participants. A verbal informed consent was taken from the students as well as their teachers. They were also given the assurance that data taken from them will be remained confidential and will only be used for research purposes. Participants were tested in groups with an average of 35 participants in each group.

Results

Pearson product-moment correlation was used to find out the relationship between family cohesion, interpersonal skills, and EBPs in adolescents.

Table 1 shows that family cohesion is positively correlated with interpersonal skills (r = .31, p < .001) and negatively associated with EBPs (r = − .38, p < .001). Furthermore, findings also depicted interpersonal skills are negatively correlated with EBPs (r = − .30, p < .001). These findings suggest that adolescents perceiving higher level of family cohesion will have greater interpersonal skills and lower EBPs. Moreover, higher level of interpersonal skills is also linked with lower level of EBPs in adolescents.

Table 1.

Intercorrelations Among Family Cohesion, Interpersonal Skills, and Emotional–Behavioral Problems (EBPs) in Adolescents (N = 1,452).

Variables	M	SD	FC	IPS	EBPs
FC	122.41	16.65	-	.31***	−.38***
IPS	88.18	24.57	-	-	−.30***
EBPs	86.86	41.57	-	-	-

Note. FC = family cohesion; IPS = interpersonal skills.

***p < .001, df = 1,451.

Findings revealed significant relationship among study variables. Therefore, the moderating role of interpersonal skills in the association between family cohesion and EBPs was explored using Hayes’s (2018) bootstrapping approach (see Figure 1).

Table 2 indicates that family cohesion (B = −1.06, SE = .06, p < .001) and interpersonal skills (B = − .21, SE = .04, p < .001) were found significant predictors of EBPs. Moreover, findings also showed that the interaction effect of family cohesion and interpersonal skills (B = − .01, SE = .00, p < .001) was also significant. Therefore, the condition effects of family cohesion on EBPs at different levels of interpersonal skills were analyzed, where at low level of interpersonal skills (B = − .84, SE = .08, p < .001), the association between family cohesion and EBPs is weak when compared to moderate (B = −1.08, SE = .07, p < .001) and high (B = −1.30, SE = .09, p < .001) levels of interpersonal skills. As the level of interpersonal skills is increasing, the association between family cohesion and EBPs is also increasing. Hence, we can conclude that interpersonal skills have an enhancing effect in the association between family cohesion and EBPs in adolescents. The interaction plot is given below.

Table 2.

Regression Analysis Examining the Interaction Effect of Family Cohesion and Interpersonal Skills on Emotional–Behavioral Problems (EBPs) (N = 1,452).

Variables	EBPs
Variables	B	SE	95% CI
Constant	88.13***	1.04	[86.08, 90.18]
Family cohesion	−1.06***	.06	[−1.19, − .94]
Interpersonal skills	−.21***	.04	[.12, .29]
Family cohesion × interpersonal skills	−.01***	.00	[ − .02, − .01]
Low interpersonal skills	−.84***	.08	[ − .99, − .69]
Moderate interpersonal skills	−1.08***	.07	[−1.21, − .95]
High interpersonal skills	−1.30***	.09	[−1.48, −1.12]
R²	.16
F	93.76***

***p < .001.

Discussion

The childhood and adolescent periods are considered a fundamental and important period of growth and development of an individual's life (Tu et al., 2020) that are associated with numerous challenges and pressures including physical growth and changing emotional and social demands that put adolescents at a higher risk for developing several problems (Park et al., 2020; Tu et al., 2020) including social, emotional, and behavioral problems (Dagvadorj et al., 2019; Park et al., 2020). Usually, these problems experienced by children and adolescents are known as EBPs (Saleem, 2011) and having long-lasting adverse consequences including loneliness, social isolation, poor academic performance, low self-esteem, suicidal ideation, and psychopathology in later life (Kumar, 2019; Maxwell & Adaugo, 2019; Oh & Song, 2018; Selamu & Singhe, 2018). Therefore, considering the negative outcomes of EBPs in adolescents, researchers are now considering to explore the risk and protective factors of EBPs (Zahra & Saleem, 2021a). The current study identified the moderating role of interpersonal skills in the association between family cohesion and EBPs.

Findings of this study depicted a positive relationship between family cohesion and interpersonal skills. Previous empirical literature also supported these results indicating that higher level of emotional bonding with family helps adolescents in learning social competence and skills (Jeon & Neppl, 2019; Kim et al., 2020; Lyell et al., 2020; Saleem et al., 2019). Family is the fundamental and basic social world in which children interact. Children and adolescents living in cohesive families also learn social values and skills from parents and family members through modeling (Bandura, 1986; Kim et al., 2020; Vygotsky, 1962). In this way, a cohesive family can become a source of social competence and skills in children and adolescents. Furthermore, Vygotsky (1962) postulated that family practices and values greatly influence the social development of children and adolescents as these familial beliefs, values, and skills are transmitted across generations.

Additionally, in line with previous literature, results of current study also revealed significant negative association of family cohesion (Chang et al., 2020; Harris et al., 2020; Hasking et al., 2020; Zubizarreta et al., 2019). A cohesive and supportive family assist the adolescent in reducing EBPs by providing support and connectedness in stressful circumstances (Wang et al., 2018). Furthermore, these findings are more meaningful in the cultural context of Pakistan. Pakistan is a traditional collectivistic culture in which family plays a fundamental role in the psychosocial and emotional development of an individual (Saleem et al., 2019). Parental involvement, sharing with family members, and family cohesiveness, bonding, and support play a more important role than the individual's own social and emotional demands and preferences (Saleem et al., 2015). Subsequently, children and adolescents are more dependent on their families than individualistic society, therefore, having a higher level of emotional bonding with family members tends to influence the child's development more considerably reducing the probability of developing EBPs and mental health issues in later life.

Moreover, findings of this study also indicated significant negative association between interpersonal skills and EBPs. Previous literature also confirmed this finding (Dykstra et al., 2020; Elsina & Martinsone, 2020; Saleem et al., 2019; Memmott-Elison et al., 2020). As Pakistan is a collectivistic culture, social cohesion, interaction, and values are preferred over personal goals and values (Nadeem et al., 2018; Zahra et al., 2020). This social cohesion and interactions may create a sense of social support which assists adolescents in reducing EBPs (Saleem et al., 2019). On the other hand, adolescents having poor social skills and social cohesion, and elevated levels of interpersonal difficulties are more vulnerable to develop EBPs.

Likewise, results revealed that interpersonal skills moderate the association between family cohesion and EBPs. Interpersonal skills have enhancing effect in the association between family cohesion and EBPs (see Figure 2). As the level of interpersonal skills increases, the association between family cohesion and EBPs gets strengthens. Previous literature also supported these findings indicating that family functioning and interpersonal skills jointly influence the level of EBPs (Lin & Tsai, 2016; Malaquias et al., 2015; Saleem et al., 2019). Not only the level of family cohesion determines the EBPs, but the level of interpersonal skills determines how much family cohesion is influencing the level of EBPs in adolescents. Therefore, in order to reduce the EBPs in adolescents, we have to boost the level of interpersonal and social skills as well as the level of family cohesion.

Limitations and recommendations

In spite of significance of the current study, there are some drawbacks as well. Fist, data were collected merely from urbanized population, therefore, it is recommended for upcoming studies to get data from rural population as well and compare both populations. Moreover, this study had taken into account adolescents only from government-run school setting, future research can be carried out on private and madrassa school systems as well. Additionally, self-report measures were used in this study to collect data from adolescents. In the future triangular approach can be used to get children, parents, and teachers’ views as all these resources would produce different types of information.

Implications

The current research has numerous practical implications. First, this study will give a unique opportunity to explore the determinants of EBPs in adolescents in the Pakistani context. Clinical and family psychologists can reduce EBPs in children by working with these determinants. Hence, problems can be catered to at earlier stages and timely intervention to students can be given. Second, based on this study results, we can conduct growth groups in schools to teach interpersonal skills to students to overcome their EBPs. Finally, we can also conduct workshops for the whole family in which we can teach certain strategies to improve family cohesion and maintain a supportive environment in the family so that EBPs can be reduced.

Conclusion

Adolescence is the most critical period of an individual life that is marked by numerous familial, physical, and social challenges that put adolescents at a higher risk for developing EBPs. These EBPs in adolescents are not linked to a single factor but an interplay of several factors. In this research, the researcher explored that family cohesion and interpersonal skills jointly contribute toward the development and maintenance of EBPs in adolescents.

Footnotes

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Family Cohesion and Emotional–Behavioral Problems in Pakistani Young Children: A Moderating Role of Interpersonal Skills

Abstract

Keywords

Introduction

Method

Participants

Measures

Family Cohesion Scale (FCS)

Interpersonal Skills Scale (IPSS)

School Children Problem Scale (SCPS)

Procedure

Results

Discussion

Limitations and recommendations

Implications

Conclusion

Footnotes

Declaration of Conflicting Interests

Funding

ORCID iD

References