When caring becomes a burden: childhood parentification and its links to relationship styles, depression, and anxiety in young adults

Abstract

Background

Parentification involves children assuming adult-like responsibilities within the family and has been linked to both adverse and adaptive psychological outcomes. However, the interpersonal mechanisms underlying its association with emotional well-being remain insufficiently understood.

Methods

This study examined the associations between different forms of childhood parentification and depression and anxiety in a sample of 448 Turkish university students (mean age = 20.95 ± 1.57), with particular attention to the mediating roles of interpersonal relationship styles and problem-solving styles.

Results

Parent-focused parentification was positively associated with depression (r = .094, p = .046) and anxiety symptoms (r = .181, p < .001). Interpersonal relationship styles mediated the associations between parent-focused parentification and depression and anxiety symptoms; toxic relationship styles showed a stronger mediating effect for depression (indirect effect = 0.036, 95% CI [0.0110, 0.0678]) and served as the sole mediator for anxiety (indirect effect = 0.040, 95% CI [0.0160, 0.0950]) while nourishing relationship styles demonstrated a weaker negative indirect effect on depression compared to toxic relationship styles (indirect effect = -0.030, 95% CI [-0.0598, -0.0098]). Sibling-focused parentification was associated with anxiety (r = .113, p = .023) but not depression. In contrast, perceived benefits of parentification were negatively associated with depression (r = − .295, p < .001) and anxiety (r = − .168, p < .001) and positively associated with nourishing relationship styles (r = .314, p < .001). Problem-solving styles did not emerge as significant mediators.

Conclusions

The findings suggest that the psychological effects of parentification are shaped primarily by interpersonal relationship dynamics. Toxic relationship styles appear to play a key role in linking burdensome caregiving roles with depression and anxiety. These results highlight the importance of strengthening healthy interpersonal relationship patterns and supporting young adults who have experienced high levels of parent-focused parentification. Interventions that focus on improving relational boundaries, enhancing emotional support, and fostering more adaptive relationship styles may help mitigate the long-term mental health risks associated with early caregiving responsibilities, while promoting the potential protective benefits of meaningfully perceived parentification experiences.

Introduction

Parentification: concept, theoretical framework, and psychological outcomes

Parents are generally expected to meet their children’s basic physical and psychological needs [1–3]. Adequate and responsive parenting is one of the fundamental conditions for healthy child development [4]. However, this expectation may not always be met. When parents face psychological, emotional, or practical limitations (such as illness, financial strain, or broader caregiving inadequacies) they may become increasingly reliant on their children, thereby allowing or compelling them to assume developmentally inappropriate adult-like roles within the family [5, 6]. This situation is mostly conceptualized in the literature as “parentification” [7] and is also expressed with similar concepts such as “spousification” [8] or childhood “adultification” [9].

In families where parentification is observed, children become involved in subsystems to which they do not belong. The boundaries between the parent, spouse, child, and sibling subsystems within the family become blurred or disappear, and this situation is incompatible with healthy family functioning [10]. However, relationships in which parents take on most of the care and responsibility and psychological boundaries are maintained are one of the cornerstones of child development [11, 12]. In families where boundaries are violated, the hierarchical structure is reversed; children become part of the executive system where family decisions are made, while parents and other adults exhibit limited power and control over the family system [13]. In general, assuming the role of caregiving at a young age can lead to traumatic and psychologically negative outcomes when it involves responsibilities that exceed the individual’s developmental level and age-appropriate psychosocial competencies, and when this situation turns into a long-term, intensive caregiving burden [14]. Studies focusing on early childhood have shown that children who put their own needs second and take on responsibilities for which they are not developmentally ready experience negative effects on their social and emotional development [15, 16]. Indeed, a meta-analysis study reported that individuals who experienced parental neglect during childhood have an increased risk of developing psychopathology in adulthood [16]. Studies examining the effects on mental health also indicate that taking on age-inappropriate responsibilities during childhood may be associated with an increase in symptoms of depression [17, 18] and anxiety [19, 20] in later years. Building on these findings, recent evidence further demonstrates that early caregiving or parentified roles are linked not only to internalizing symptoms such as depression and anxiety but also to elevated stress and reduced self-esteem, with these effects often persisting into adolescence and adulthood [21–23].

However, it is important to note that parentification does not always occur in uniformly harmful forms, and under certain relational conditions, some adaptive or positive outcomes may also emerge. Some studies show that parentification can have not only negative but also some positive outcomes [24, 25]. Prior studies have shown that parentification may be associated with the development of positive emotions and increased optimism [24], and when it occurs within a supportive relational context, it may contribute to enhanced self-esteem [25]. These varied outcomes suggest that the effects of parentification cannot be understood in isolation but must be interpreted within broader relational and systemic frameworks.

Interpersonal relationships and parentification

From a theoretical perspective, the present study draws on family systems theory, which emphasizes boundary violations and role reversals in dysfunctional family structures, as well as attachment theory, which highlights the long-term relational consequences of early caregiving experiences. In addition, developmental perspectives on coping and autonomy provide a framework for understanding how early caregiving responsibilities may shape problem-solving orientations in later life. Within this theoretical context, interpersonal relationship styles represent a key pathway through which early caregiving experiences may shape individuals’ social functioning and mental health.

Interpersonal relationships are social bonds and affiliations that people develop, characterized by ongoing influence on each other’s thoughts, feelings, and behaviors [26]. Within this framework, interpersonal relationship styles can be conceptualized as relatively stable and learned patterns of relating to others, shaped by early caregiving experiences and boundary dynamics within the family. Because parentification involves early role reversals and blurred relational boundaries, it is theoretically expected to influence the development of interpersonal relationship styles. Consistent with this view, the parentification process can negatively affect the child’s personality development and interpersonal functioning [27]. Moreover, these effects are not limited to childhood but also reflect in the individual’s relationships in adulthood [28]. However, it has also been observed that parentification does not always have one-sided negative consequences on interpersonal processes. In a study conducted with university students, a positive relationship was found between the level of parentalization and the empathy dimension of interpersonal relationships, and it was shown that parentalization significantly predicts empathy [29]. Beyond interpersonal functioning, early caregiving demands may also influence how individuals approach challenges, potentially shaping their problem-solving style.

Independent problem-solving style in the context of parentification

Beyond interpersonal processes, parentification may also shape individual coping and problem-solving orientations. Independent problem-solving styles reflect an individual’s propensity to approach challenges autonomously and rely on personal resources when dealing with difficulties [30]. Children who assume adult-like responsibilities at an early age are often required to manage challenges independently, which may foster self-reliance and reduce help-seeking behaviors. Prior research indicates that attachment and relationship patterns are closely associated with individuals’ coping and regulatory strategies, suggesting that stable interactional styles are linked with cognitive and emotional approaches to managing difficulties [31]. Such evidence provides theoretical support for including independent problem-solving as a factor that may mediate the effects of early caregiving experiences on psychological outcomes. From a developmental perspective, this prematurely acquired autonomy may function as both an adaptive resource and a potential risk factor, depending on the context and availability of emotional support.

Parentification in the Turkish context and study aims

In addition to the growing international literature, empirical studies conducted in Türkiye have increasingly examined childhood parentification and its associations with psychological well-being and relational functioning, particularly among young adult populations. A study conducted with Turkish university students demonstrated that different dimensions of parentification are associated with distinct psychological outcomes. Specifically, sibling-focused parentification was positively associated with depression, anxiety, and stress symptoms, whereas perceived benefits of parentification were negatively related to these indicators of psychological distress. The findings further indicated that parent-focused parentification was related to anxiety and stress but not significantly associated with depressive symptoms [32]. Furthermore, research conducted with individuals aged 18–25 in the Turkish context has documented the relational consequences of childhood parentification, showing that both parent-focused and sibling-focused parentification are positively associated with codependency (a relational pattern characterized by excessive focus on others’ needs at the expense of one’s own autonomy) with differentiation of self-serving as a mediating factor [33]. Taken together, these findings indicate that parentification experiences are linked to enduring psychological and relational dynamics in Turkish young adults, underscoring the importance of further examining interpersonal mechanisms associated with early caregiving role reversals.

Current research suggests that parentification may function as both a risk factor and a potential source of adaptation, depending on its form and context. However, the mechanisms through which parentification is linked to psychological symptoms remain insufficiently understood. In particular, the ways in which parentification is associated with individuals’ interpersonal relationship styles and problem-solving orientations, and whether these processes mediate the effects of parentification on depression and anxiety, have not been systematically examined. Therefore, the present study aimed to investigate the associations between parentification and depressive and anxiety symptoms by examining interpersonal relationship styles and dependent/independent problem-solving styles within a comprehensive mediation model.

Hypotheses

Based on the existing literature and the conceptual framework of the study, several hypotheses were formulated.

Direct associations

• H1a. Parent-focused parentification (PFP) will be positively associated with depressive symptoms.

• H1b. Parent-focused parentification (PFP) will be positively associated with anxiety symptoms.

• H1c. Sibling-focused parentification (SFP) will be positively associated with anxiety symptoms and was also expected to be positively associated with depressive symptoms.

• H1d. Perceived benefits of parentification (PBP) will be negatively associated with depressive symptoms.

• H1e. Perceived benefits of parentification (PBP) will be negatively associated with anxiety symptoms.

Mediation through interpersonal relationship styles

• H2a. Toxic interpersonal relationship style will mediate the association between PFP and depressive symptoms.

• H2b. Toxic interpersonal relationship style will mediate the association between PFP and anxiety symptoms.

• H2c. Nourishing interpersonal relationship style will mediate the association between PFP and depressive symptoms.

• H2d. Nourishing interpersonal relationship style will mediate the association between PFP and anxiety symptoms.

Mediation through problem-solving style

• H3. Independent problem-solving style will mediate the associations between parentification dimensions and psychological outcomes (depression and anxiety).

Hierarchical regression predictions

• H4a. After controlling for sociodemographic variables, parent-focused parentification (PFP) will significantly predict higher levels of depressive symptoms.

• H4b. After controlling for sociodemographic variables, parent-focused parentification (PFP) will significantly predict higher levels of anxiety symptoms.

• H4c. After controlling for sociodemographic variables, sibling-focused parentification (SFP) will predict higher levels of both depressive and anxiety symptoms.

• H4d. After controlling for sociodemographic variables, perceived benefits of parentification (PBP) will negatively predict depressive symptoms.

• H4e. After controlling for sociodemographic variables, perceived benefits of parentification (PBP) will negatively predict anxiety symptoms.

Interpersonal relationship styles as predictors

• H5a. Toxic interpersonal relationship style will positively predict depressive symptoms.

• H5b. Toxic interpersonal relationship style will positively predict anxiety symptoms.

• H5c. Nourishing interpersonal relationship style will negatively predict depressive and anxiety symptoms.

Materials and methods

Participants

A total of 454 participants were distributed in the study, and 6 participants who were found to be incomplete were excluded from the scope of the study. The analyses were conducted on 448 university students who responded and completed the scales in full. The participants consisted of students from the Faculty of Economics and Administrative Sciences at a state university. This faculty was chosen because it is the largest faculty at the university, thus enabling access to a broad student body from diverse family backgrounds.

Participants were recruited using a convenience sampling method. Data were collected face-to-face by the researcher in classroom settings outside of class hours.

In the study statistical evaluations related to the concept of sibling-focused parentification were conducted, excluding the data of 47 participants who were only children, and the analyses were performed on the remaining 401 participants. Furthermore, the sample size of the study was calculated to be at least 349 students, with a 95% confidence level and a 5% margin of error. The obtained sample size was found to meet this criterion.

Participation in the study was voluntary. After being informed about the purpose and procedures, all participants provided written consent. Students enrolled in the Faculty of Economics and Administrative Sciences who agreed to participate were included in the study, whereas those who declined participation were excluded.

Data collection measurements

Socio-demographic characteristics

This form included questions assessing participants’ basic demographic and background information, such as age, gender, marital status, place of residence during most of their lives, primary caregiver in childhood, family income, family structure, parental education levels, number of siblings, perceived academic success, perceived quality of peer and romantic relationships, and history of psychiatric diagnosis.

Parentification inventory

The Parentification Inventory, developed by Hooper [34], is a retrospective self-report measure assessing childhood parentification experiences. The scale consists of 22 items rated on a 5-point Likert scale (1 = never, 5 = always) and includes three subscales: Parent-Focused Parentification (PFP), Sibling-Focused Parentification (SFP), and Perceived Benefits of Parentification (PBP). Parent-Focused Parentification (PFP) comprises 12 items assessing responsibilities directed toward parents. Sibling-Focused Parentification (SFP) includes 7 items measuring caregiving responsibilities assumed toward siblings. Perceived Benefits of Parentification (PBP) consists of 3 items assessing individuals’ positive perceptions and meanings attributed to their parentification experiences. Higher scores indicate higher levels of parentification. The Turkish validity and reliability of the scale were established by Köyden and Uluç. Consistent with the Turkish adaptation study, the item composition of the Parentification Inventory subscales differed slightly from the original version. In the Turkish validation, the Parent-Focused Parentification subscale was composed of 11 items, the Sibling-Focused Parentification subscale consisted of 5 items, and the Perceived Benefits of Parentification subscale included 6 items. Accordingly, subscale scores were calculated based on the scoring procedure recommended in the Turkish validation [35], reflecting culturally and psychometrically appropriate modifications to the original item structure [35]. In the present study, Cronbach’s alpha coefficients indicated internal consistency for the Parent-Focused Parentification (Cronbach’s alpha = 0.72), Sibling-Focused Parentification (Cronbach’s alpha = 0.69), and Perceived Benefits of Parentification (Cronbach’s alpha = 0.74) subscales.

Interpersonal relationships scale

The Interpersonal Relationships Scale was developed by Şahin, Durak, and Yasak for use in Turkish populations [36]. The scale consists of 31 items rated on a 4-point Likert scale (0 = never, 3 = always). Factor analyses conducted in the original study identified two subscales: (1) nourishing relationship styles, reflecting positive interpersonal functioning, and (2) toxic (inhibitory) relationship styles, reflecting negative interpersonal patterns. Higher scores indicate greater endorsement of the respective relationship style [36]. In the present study, Cronbach’s alpha values for the nourishing and toxic relationship style subscales were 0.79 and 0.81, respectively.

Independent-interdependent problem-solving style scale

The scale was developed by Rubin et al. [37], and its second version was subsequently revised and psychometrically evaluated by Sanatkar and Rubin [38]. Scale was adapted into Turkish by Ekşi and Tufan [39]. The scale was developed to measure whether individuals prefer to solve problems with help from others or on their own. Although the scale was developed as a single-factor measure, analysis revealed a two-factor structure (Dependent problem solving and Independent problem solving). The scale consists of 12 items in the first version and 10 items in the second version. The second version of the Independent–Interdependent Problem-Solving Style Scale, consisting of 10 items, was used in the present study. When scoring the scale based on independent problem solving, the average score is calculated by reversing the dependent problem-solving elements. The scale is a 7-point Likert-type scale (1 = Strongly disagree, 7 = Strongly agree) [39]. In the present study, the internal consistency of the independent problem-solving scale was with Cronbach’s alpha 0.78.

Beck depression inventory

Developed by Beck and colleagues, the Beck Depression Inventory was designed to assess the behavioral symptoms of depression in adolescents and adults [40]. The Turkish adaptation and validation were conducted by Hisli [41], who reported strong psychometric properties for the Turkish version, including a Cronbach’s alpha of 0.80 and a multidimensional factor structure. The scale consists of 21 symptom categories, which are classified into somatic, emotional, and cognitive dimensions. Typically, a cut-off score of 17 is accepted, with the maximum possible score being 63. Higher scores indicate greater severity of depressive symptoms [41]. In the present study, the internal consistency of the Beck Depression Inventory was Cronbach’s alpha = 0.84.

Beck anxiety inventory

The Beck Anxiety Inventory was developed by Beck and colleagues to measure the presence and severity of anxiety symptoms [42]. It is a 21-item self-report scale that assesses the severity of anxiety symptoms on a continuous scale. Each item is rated on a 4-point scale from 0 to 3, where 0 = “not at all,” 3 = “severely—I could barely stand it,” yielding a total score between 0 and 63 [42]. The Turkish adaptation, including validity and reliability analyses, was conducted by Ulusoy, Şahin, and Erkmen, who reported strong psychometric properties, including excellent internal consistency (Cronbach’s alpha = 0.93), test–retest reliability of r = .75, and a factor structure consistent with the original scale [43]. In the present study, the internal consistency of the Beck Anxiety Inventory was Cronbach’s alpha = 0.91.

Process

Data were collected face-to-face by the researcher in the classroom setting outside of class hours. Participants were informed about the purpose of the study, the principles of confidentiality, and the voluntary nature of their participation. Written informed consent was obtained from each participant prior to the administration of the study scales. The application took approximately 20–25 min. Data were collected from May to September, 2025.

Ethical principles

The study was approved by the Ethics Committee of the Faculty of Medical Sciences at Muğla Sıtkı Koçman University, Türkiye (Decision No. 93, Protocol No. 250056), dated May 3, 2025. Informed consent forms were obtained from all participants, and ethical principles were observed throughout the research process.

Statistical analysis

Statistical analyses were conducted using IBM SPSS Statistics for Mac, version 27.0 (IBM Corp., Armonk, NY). A 95% confidence interval and a significance level of p < .05 were employed throughout the analysis. For continuous variables, descriptive statistics are presented as mean ± standard deviation. Categorical variables are described using frequencies and percentages. Correlation analyses were conducted to explore the relationships between continuous variables.

We employed mediation analysis with bootstrapping, following the recommendations and procedures outlined by Preacher and Hayes [44]. Data analysis was conducted using PROCESS macro, a software tool developed by Hayes for mediation analysis. Bootstrapping with 5000 resamples was employed for estimating indirect effects. In mediation analysis using bootstrapping, the 95% cnfidence interval (CI) must not include zero for the results to allow for the hypothesized indirect effect [45]. In our study, Model 4 was used in Process Macro.

Prior to the main analyses, assumptions of linearity, homoscedasticity, independence of errors, and multicollinearity were examined for all regression models. Visual inspection of scatterplots and residual plots supported linearity and homoscedasticity. Durbin–Watson values indicated independence of errors, and variance inflation factor (VIF) values were below commonly accepted thresholds, suggesting no multicollinearity issues.

Results

In this study, data from 448 university students enrolled in higher education were examined, and the concept of parentification in childhood (parent-focused parentification, sibling-focused parentification, and perceived positive parentification) was investigated in relation to depression, anxiety, interpersonal relationship styles, and dependent/independent problem-solving styles. Findings are summarized under the following headings based on the analyses conducted.

Socio-demographic data

Of the 448 participants, 60.5% (n = 271) were women and 39.5% (n = 177) were men. The mean age of the participants was 20.95 ± 1.57 years (range: 18–25). Detailed sociodemographic characteristics are presented in Table 1.

Table 1.

Sociodemographic data

	MeanSD, n(%), (min-max)
Age	20.95 ± 1.57 (min:18 max:25)
Gender
Female	271 (60.5)
Male	177 (39.5)
Marital Status
Married	4 (0.9)
Single	441 (98.4)
Divorced	3 (0.7)
Where most of your life takes place?
Village	64 (14.3)
Town	185 (41.3)
City	199 (44.4)
Who took care of you for most of your infancy/childhood?
Nuclear Family (Mother, Father, Brother/Sister)	394 (87.9)
Caregiver, Nursery or Kindergarten	9 (2.0)
Grandmother or Grandfather	45 (10.1)
Family income
Low	19 (4.3)
Middle	311 (69.4)
Good	118 (26.3)
What was the structure of your family like during your childhood/adolescence?
Nuclear family	414 (92.4)
Divorced family	30 (6.7)
One or both parents have died family	4 (0.9)
Mother education status
Secondary school and below	271 (60.4)
High school and above	177 (39.6)
Father education status
Secondary school and below	223 (49.7)
High school and above	225 (50.3)
Number of siblings (including you)	2.66 ± 1.31 (min:0-max:10)
How would you describe your academic success?
Low	34 (7.6)
Middle	284 (63.4)
Good	130 (29.0)
How would you describe your relationships with your lovers/peers/friends?
Low	16 (3.6)
Middle	121 (27.0)
Good	311 (69.4)
Do you have a psychiatric diagnosis (made by a doctor)?
Yes	54 (12.1)
No	394 (87.9)
If you have a psychiatric diagnosis (made by a doctor), which one is it?
Attention Deficit and Hyperactivity Disorder	14 (3.1)
Major Depressive Disorder	14 (3.1)
Anxiety Disorders	33 (7.3)
Obsessive Compulsive Disorder	8 (1.7)
Personality Disorders	4 (0.8)
Alcohol/Substance Use Disorder	1 (0.2)
Mood Disorders	8 (1.7)
Psychotic Disorder	2 (0.4)

Scale data

The distribution of scores obtained from the scales is shown in Table 2.

Table 2.

Scales data

	MeanSD, (min-max)
Parentification Inventory
Parent-Focused Parentification	28.32 ± 8.98 (min:11 max:85)
Sibling-Focused Parentification	10.02 ± 3.69 (min:5 max:22)
Perceived Benefits of Parentification	20.99 ± 4.78 (min:6 max:30)
Interpersonal Relationships Scale
Nourishing Relationship Style	32.92 ± 6.85 (min:6 max:48)
Toxic Relationship Style	13.21 ± 6.68 (min:1 max:36)
Independent-Interdependent Problem-Solving Style Scale	4.15 ± 1.02 (min:1.40 max:7)
Beck Depression Inventory	15.00 ± 9.30 (min:0 max:48)
Beck Anxiety Inventory	15.15 ± 12.65 (min:0 max:64)

Correlations between parentification types, depression, anxiety, interpersonal relationship styles, and problem-solving styles

A positive and significant relationship was found between PFP and depression scores (r = .094, p = .046). Similarly, a positive and significant relationship was found between PFP and anxiety scores (r = .181, p < .001). SFP was only found to be positively related to anxiety scores (r = .113, p = .023). PBP was positively related to a nourishing interpersonal relationship style (r = .314, p < .001) and negatively related to depression scores (r = − .295, p < .001) and anxiety scores (r = − .168, p < .001). In terms of interpersonal relationship styles, PFP is positively related to both the nourishing relationship style (r = .145, p = .002) and the toxic relationship style (r = .249, p < .001). Additionally, a positive correlation was observed between PFP and independent problem-solving style (r = .128, p = .007). All results related to the correlation analysis are presented in Table 3.

Table 3.

Correlation data

Variables	1	2	3	4	5	6	7	8
1. Parent-Focused Parentification	—	0.604***	− 0.036	0.094*	0.181***	0.145**	0.249***	0.128**
2. Sibling-Focused Parentification	0.604***	—	− 0.056	0.057	0.113*	0.029	0.084	0.023
3. Perceived Benefits of Parentification	− 0.036	− 0.056	—	− 0.295***	− 0.168***	0.314***	− 0.067	− 0.017
4. Beck Depression Inventory	0.094*	0.057	− 0.295***	—	0.465***	− 0.146**	0.162***	0.089
5. Beck Anxiety Inventory	0.181***	0.113**	− 0.168***	0.465***	—	− 0.028	0.168***	-0.01
6. Nourishing Relationship Style	0.145**	0.029	0.314***	− 0.146**	− 0.028	—	− 0.040	− 0.040
7. Toxic Relationship Style	0.249***	0.084	− 0.067	0.162***	0.168***	− 0.040	—	0.253***
8.Independent Problem-Solving Style Scale	0.128**	0.024	− 0.017	0.089	− 0.001	− 0.040	0.253***	—

*p < .05. **p < .01. ***p < .001

Mediation analyses

PFP (X) indirectly and simultaneously (parallel) affects depression scores (Y) through nourishing relationship style (M1) and toxic relationship style (M2). In other words, the effect of PFP on depression scores occurs simultaneously or in parallel through the nourishing relationship style and the toxic relationship style. Since the bootstrap confidence intervals obtained did not include the value 0, the simultaneous mediation analysis was considered meaningful (Indirect Effect (IE)= (a₁b₁); β= -0.030; 95% Confidence Interval (CI) [(-0.0598) -(-0.0098)]; Indirect Effect (IE) = (a₂b₂); β = 0.036; 95% Confidence Interval (CI) [(0.0110) - (0.0678)]). In addition, the PROCESS Macro’s indirect effects comparison option was used to compare the mediating effects. According to the results obtained; the indirect effect of PFP on depression scores (via the toxic relationship style) was found to be statistically greater than the indirect effect of PFP on depression scores (via the nourishing relationship style) because there was no value of 0 between the confidence intervals. (ΔIndirect Effect =: (a₁b₁-a₂b₂); β = -0.066; 95% CI: [(-0.1072) -(-0.0317)]. The parallel mediating effect is shown in Fig. 1. In addition, it has been determined that toxic relationship styles have a mediating effect on the relationship between PFP and anxiety. Information regarding these mediating effects is shown in Fig. 2. Independent problem-solving style, however, did not play a significant mediating role in the relationships with either depression or anxiety.

Fig. 1.

Parallel mediation effect. Note. X = Parent-focused parentification; Y = Depression; M1 = Nourishing relationship style; M2 = Toxic relationship style. Path coefficients represent unstandardized regression estimates. The indirect effect of parent-focused parentification on depression through nourishing relationship style was significant (a₁b₁ = -0.030, 95% CI [-0.0598, -0.0098]). The indirect effect through toxic relationship style was also significant (a₂b₂ = 0.036, 95% CI [0.0110, 0.0678]). The difference between indirect effects was significant (a₁b₁ − a₂b₂ = -0.066, 95% CI [-0.1072, -0.0317])

Fig. 2.

The mediating role of toxic relationship style in the relationship between parent-focused parentification and anxiety. Note. X = Parent-focused parentification; M = Toxic relationship style; Y = Anxiety. Path a (β = 0.168, p < .001); Path b (β = 0.293, p = .001). The indirect effect of parent-focused parentification on anxiety through toxic relationship style was significant (axb = 0.040, 95% CI [0.0160, 0.0950]). The direct effect (c′) remained significant (β = 0.236, p < .001), as did the total effect (c = 0.286, p < .001)

Hierarchical regression analyses

In hierarchical regression analyses, sociodemographic variables were included in the model in the first block and explained 8.2% of the variance in depression scores. In Block 1, family income (β = − 0.174, p < .001), number of siblings (β = − 0.114, p = .026), and how would you describe your romantic/friendship relationship (β = − 0.176, p < .001) were statistically significant predictors of depression.

When parentification styles were added in the second block, the variance explained by the model increased to 15.4%. In Block 2, perceived benefits of parentification (PBP) was the only significant predictor of depression (β = − 0.291, p < .001).

When interpersonal relationship styles and problem-solving styles were included in the third block, the model explained 19.1% of the total variance. In Block 3, toxic interpersonal relationship style significantly predicted higher depression scores (β = 0.173, p < .001), whereas nourishing relationship style and independent problem-solving style were not significant.

A similar analysis was conducted for anxiety symptoms. In Block 1, demographic variables explained 6.2% of the variance. Gender was the only significant predictor (β = − 0.239, p < .001).

When parentification styles were introduced in Block 2, the explained variance increased to 15.5%. In this block, PFP (β = 0.218, p < .001) and PBP (β = − 0.228, p < .001) were significant predictors of anxiety.

Finally, the addition of interpersonal relationship styles and problem-solving styles increased the explained variance to 19.0%. In Block 3, toxic relationship style significantly predicted anxiety (β = 0.201, p < .001), whereas nourishing relationship style and independent problem-solving style were not significant. All findings from the hierarchical regression analyses are presented in Tables 4 and 5.

Table 4.

Hierarchical regression analysis predicting depression scores

Variables	β	t	p
Block 1: Demographics
Age	0.069	1.371	0.171
Gender	− 0.055	-1.118	0.264
Marital status	− 0.025	− 0.508	0.611
Family income	− 0.174	-3.549	< 0.001
Family structure	0.045	0.899	0.369
Number of siblings	− 0.114	-2.241	0.026
Romantic/friendship relationship	− 0.176	-3.543	< 0.001
Block 2: Parentification types
Parent-focused parentification	− 0.005	− 0.077	0.939
Sibling-focused parentification	0.060	0.992	0.322
Perceived Benefits of Parentification	− 0.291	-5.590	< 0.001
Block 3: Relationship styles and problem solving
Independent Problem-Solving Style Scale	0.034	0.701	0.484
Nourishing Relationship Style	− 0.085	-1.647	0.100
Toxic Relationship Style	0.173	3.484	< 0.001

Final model: R² = 0.191, p < .001

p < 0.05 is statistically significant

Table 5.

Hierarchical regression analysis predicting anxiety scores

Variables	β	t	p
Block 1: Demographics
Age	0.028	0.548	0.584
Gender	− 0.239	-4.765	< 0.001
Marital status	− 0.041	− 0.834	0.405
Family income	− 0.034	− 0.694	0.488
Family structure	0.055	1.093	0.275
Number of siblings	0.013	0.244	0.807
Romantic/friendship relationship	− 0.031	− 0.626	0.531
Block 2: Parentification types
Parent-focused parentification	0.218	3.559	< 0.001
Sibling-focused parentification	0.014	0.241	0.810
Perceived Benefits of Parentification	− 0.228	-4.380	< 0.001
Block 3: Relationship styles and problem solving
Independent Problem-Solving Style Scale	− 0.056	-1.167	0.244
Nourishing Relationship Style	0.016	0.316	0.752
Toxic Relationship Style	0.201	4.052	< 0.001

Final model: R² = 0.190, p=.001

p < 0.05 is statistically significant

Discussion

The present study examined the associations between childhood parentification, depressive and anxiety symptoms, interpersonal relationship styles, and independent problem-solving styles in a sample of young adults. The findings indicated that parent-focused parentification was positively associated with depressive and anxiety symptoms and with both nourishing and toxic interpersonal relationship styles. Perceived benefits of parentification were negatively associated with depression and anxiety and positively associated with nourishing relationship styles. Mediation analyses revealed that interpersonal relationship styles, particularly toxic relationship styles, played a mediating role in the association between parent-focused parentification and psychological symptoms, whereas independent problem-solving styles did not emerge as a significant mediator. These findings highlight the central role of relational processes in understanding the psychological correlates of childhood parentification.

The present study found that parent-focused parentification (PFP) was positively associated with depressive and anxiety symptoms, as well as with both nourishing and toxic interpersonal relationship styles, indicating that the interpersonal consequences of parentification are multidimensional rather than unidirectional. This pattern is consistent with previous research showing that parentification is associated with internalizing symptoms such as depression and anxiety [28, 46–48] and with difficulties in close relationships, including lower constructive communication, increased avoidant and anxious attachment styles, and reduced relationship satisfaction [49–51]. At the same time, prior studies have also suggested that parentification may foster responsibility, autonomy, and self-esteem under certain conditions [52, 53] which helps explain its simultaneous association with nourishing relationship styles observed in the present study. From this perspective, the relational impact of parentification appears to depend not only on the assumption of caregiving roles itself, but also on how these responsibilities are experienced and evaluated relative to the child’s developmental capacities. At this point, the concept of “relational responsibility” may be considered to play a critical role. If the responsibility a child perceives toward their parent is disproportionately heavy in relation to their own skills and developmental needs, children will tend to experience anxiety and depressive feelings when they realize they cannot cope with this difficulty [54]. These findings extend the literature by demonstrating that the association between parent-focused parentification and psychological symptoms may be better understood through the interpersonal relationship styles that emerge in adulthood.

The results of the mediation analyses indicate that the associations between parentification and mental health symptoms are linked to interpersonal processes. Both nourishing and toxic relationship styles demonstrated parallel mediating roles in the association between parent-focused parentification (PFP) and depressive symptoms. The relatively stronger mediating effect of toxic relationship styles compared to nourishing styles suggests that negative interpersonal dynamics are more closely associated with the co-occurrence of parentification and depressive symptoms. In contrast, only toxic relationship styles emerged as a mediator in the association between PFP and anxiety, indicating that depressive and anxiety symptoms may be linked to parentification through partially distinct interpersonal pathways. The limited availability of comparable findings in the existing literature underscores the originality of the present study. Nevertheless, future longitudinal research conducted in diverse cultural contexts and with heterogeneous samples would be valuable for further clarifying these interpersonal mechanisms.

In SFP, a different pattern emerged. The study found a positive relationship between SFP and anxiety alone, with no significant relationship found with depression. This finding suggests that SFP may trigger emotional processes particularly related to anxiety but may not be equally linked to depressive symptoms. Comparable findings have been reported in previous empirical studies examining SFP. For example, Köyden and Uluç reported that SFP was associated with both anxiety and depression in women, but only with anxiety in men [55]. Arıkan Çolak, found no association between depression and anxiety in individuals with healthy siblings, but identified a positive association with both variables in individuals with siblings with special needs [56]. In addition, SFP has been found to be associated with perceived high levels of responsibility [57, 58] and low quality of life [59]. Therefore, the literature findings indicate that SFP establishes stronger connections particularly with anxiety, while the relationship with depression may vary depending on the characteristics of the sample (such as gender and whether the sibling has special needs). The fact that the presence of a sibling with special needs was not distinguished in our study may also have contributed to the lack of a significant relationship with depression. Considering this variable in future studies will contribute to revealing more meaningful patterns in different samples.

The finding that PBP is negatively associated with depression and anxiety, and that in hierarchical regression analyses, toxic relationship style (positive) and PBP (negative) emerge as the strongest predictors for depression and anxiety, demonstrates that parentification is not always pathological, but can be protective in some contexts. Children’s perceptions of assuming the parentification role play an important role in maximizing the effect of parentification on them. Parents can help their children adapt well to the parentification process by clearly delegating age-appropriate roles to them and affirming them in a positive manner [60]. The literature indicates that young people who embrace the role of parenthood experience higher self-esteem, maturity, and pride [53] and demonstrate increased responsibility, competence, and autonomy [52]. Similarly, Armstrong-Carter et al. stated that the experience of parentification can contribute to individuals acquiring practical skills that they can use to cope with difficulties throughout their lives [61].

On the other hand, it has been noted that the effects of parentification stem not only from assuming the role, but also from how the individual perceives this role. Jankowski et al. showed that the relationship between parentification and psychological symptoms largely emerges through perceived injustice [62]. This finding suggests that the negative consequences of parentification may be more related to the individual’s way of perceiving/interpreting the experience. Therefore, the results obtained reveal that parentification experiences should not be automatically considered pathological in clinical practice; at the same time, they can also be considered as potential sources of resilience, adaptation, and skill development.

Our study found a positive and significant relationship between PFP and independent problem-solving style. Indeed, it is suggested that when children have higher levels of resilience, their parentification experiences can enhance their problem-solving skills [63]. Similarly, Boumans and Dorant found in their study with university students that individual who had experienced parentification tended to use more emotion-focused problem-solving strategies [64]. With this, mediation analyses revealed that an independent problem-solving style did not play a mediating role. This finding suggests that the effects of parentification are transmitted through relational contexts and interpersonal evaluations rather than individual coping skills. The nature of parentification, whereby responsibilities are mostly experienced through interpersonal relationships (parent–child, sibling–sibling, family dynamics), may have led to individual problem-solving skills remaining secondary in this process. Furthermore, the fact that our study focused solely on the interdependent/independent dimension of problem-solving styles may have contributed to this result. This finding, which to our knowledge has not been previously reported in the literature, suggests that examining problem-solving styles within a broader framework in the future may provide deeper insights into understanding the relationship between parentification and depression and anxiety.

Limitations

This study has several limitations. First, the research was conducted solely with a sample of young adults consisting of university students. This restricts the generalizability of the findings to other age groups, life stages, or populations outside the university context. Second, the data were collected through self-report measures, which may have increased the influence of subjective factors such as social desirability or recall bias. Moreover, depression and anxiety variables were assessed using self-reported scales rather than clinical diagnoses; therefore, the findings cannot be generalized at the level of psychiatric diagnoses. Finally, the cross-sectional design of the study does not allow for causal inferences. Future research could benefit from employing longitudinal methods and incorporating multiple sources of information (e.g., reports from parents or siblings) to provide a more comprehensive understanding of the relationship between parentification and mental health.

Conclusion

This study makes a unique contribution to the literature by examining the relationship between parentification and symptoms of depression and anxiety within a university student sample, in the context of interpersonal relationship styles. Notably, the prominence of the toxic relationship style in the parallel mediation model suggests that the negative aspects of parentification may become more pronounced through interpersonal dynamics. At the same time, the findings indicate that parentification should not be viewed solely as a risk factor; under certain circumstances, it may also serve as a source of resilience and skill development. From a clinical perspective, it is important not to automatically pathologize experiences of parentification. Rather, individuals perceived burden, the approval they receive from their parents, and their interpersonal styles should be evaluated holistically. Considering these dimensions within counseling processes may facilitate a more balanced understanding of both the risk and protective effects of parentification on mental health.

Authors’ contributions

The study was designed E.G.G. E.G. collected the data. E.G. and E.G.G. performed the data analysis. E.G.G. prepared the first draft. All authors interpreted the data, contributed to writing and revision of the manuscript, and approved the final version to be published.

Funding

The authors declare that there is no fund in the study.

Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Declaratıons

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Faculty of Medical Sciences at Muğla Sıtkı Koçman University, Türkiye (Decision No. 93, Protocol No. 250056), dated May 3, 2025. We performed all the study procedures following the Declaration of Helsinki. Informed consent forms were obtained from the participants.

Competing interests

The authors declare no competing interests.