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. Author manuscript; available in PMC: 2012 Apr 1.
Published in final edited form as: J Fam Psychol. 2011 Apr;25(2):251–260. doi: 10.1037/a0023201

Coparenting Around Siblings’ Differential Treatment in Mexican-Origin Families

Anna R Solmeyer 1, Sarah E Killoren 2, Susan M McHale 3, Kimberly A Updegraff 4
PMCID: PMC3076121  NIHMSID: NIHMS276256  PMID: 21480704

Abstract

This study examined patterns of mothers’ and fathers’ differential affection and discipline toward two adolescent offspring in 243 Mexican-origin families. Grounding our work in a family systems perspective, we used interparental patterns of differential treatment as an index of the coparental alliance and tested their associations with parents’ reports of familism values, traditional gender role attitudes, and cultural orientations. We also sought to replicate prior research on European American samples linking interparental patterns of differential treatment to marital qualities (coparenting satisfaction, love, and conflict) and adolescent depressive symptoms and risky behaviors. Three interparental patterns emerged: families in which both mothers and fathers treated their two offspring equally, incongruent families in which one parent treated both offspring equally while the other parent favored one offspring, and congruent families in which both parents favored the same offspring. Most parents reported equal treatment, but others fell into the incongruent affection (30%), incongruent discipline (45%), and congruent discipline (16%) groups. Mixed model ANOVAs revealed that in families in which mothers and fathers both treated their offspring equally, parents reported higher familism values, more traditional gender role attitudes, and relatively stronger orientations to Mexican than Anglo culture. Consistent with previous research, interparental incongruence was associated with less positive marital qualities and more adolescent adjustment problems. Discussion focuses on the role of culture in shaping coparenting and the processes through which these coparenting dynamics are linked to marital and youth adjustment.

Keywords: Coparenting, Mexican American Families, Parental Differential Treatment, Marital Quality, Youth Adjustment

Parents’ differential treatment (DT) is a common family dynamic and is associated with youth adjustment problems and troubled family relationships (Deal, 1996; Shanahan, McHale, Crouter, & Osgood, 2008). Although most research treats DT by mothers and fathers as independent processes, a family systems perspective (Minuchin, 1974; O’Connor, Hetherington, & Reiss, 1998) highlights the importance of patterns of mothers’ and fathers’ DT. Indeed, some work documents links between family patterns of DT and marital and sibling relationships and youth adjustment (Kan, McHale, & Crouter, 2008; McHale, Crouter, McGuire, & Updegraff, 1995; Volling & Elins, 1998). Our goal was to replicate and extend this work by examining the cultural contexts of parents’ DT, taking into account perspectives of multiple family members.

A limitation of the family systems literature is its focus on European American families. A cultural-ecological perspective suggests, however, that cultural processes are central in shaping family values and practices and thus should be a focus of family research (Garcia Coll et al., 1996; Spencer, 1995). Indeed, an emerging literature highlights the role of Latino cultural values and practices in parenting and family dynamics (Parke et al., 2004). The present study focuses on Mexican-origin families, the largest Latino group in the US and a rapidly growing segment of the US population (U.S. Census Bureau News, 2010), to assess how cultural practices and values are linked to coparenting dynamics, specifically mother-father patterns of DT.

Our aims were threefold. First, we identified interparental patterns of DT in two-parent Mexican-origin families of adolescents, focusing on interparental incongruence, which prior work suggests reflects problems in the coparenting alliance (e.g., Kan et al., 2008). Next, we examined the role of cultural values and practices in these interparental patterns. Our final aim was to replicate results of previous studies of European American families showing that incongruence in parents’ DT is associated with problems in marital and youth adjustment.

Family Systems and Coparenting

A family systems perspective emphasizes interdependence among individual family members, subsystems (e.g., marital, sibling) within the family, and properties of the family as a whole (Minuchin, 1974). Family systems theorists argue that researchers must look beyond individual and dyadic dynamics to examine processes that link subsystems (O’Connor et al., 1998). One such process is coparenting, or how mothers and fathers coordinate, support, or undermine one another’s parenting (McHale, Kuersten-Hogan, Lauretti, & Rasmussen, 2000). Research establishes links between coparenting and both marital quality (Schoppe-Sullivan, Mangelsdorf, Frosch, & McHale, 2004) and youth well-being (Baril, Crouter, & McHale, 2007; Feinberg, Kan, & Hetherington, 2007). Coparenting processes involve triadic or larger subsystems because they include a mother, father, and at least one offspring. Some studies have used observational methods to explore coparenting dynamics (McHale et al., 2000; Schoppe-Sullivan et al.), but most research on coparenting is limited to individual measures (e.g., self-reports of coparenting), which may not capture this dynamic’s systemic nature.

We took an alternative approach to conceptualizing and measuring coparenting. Following prior research (e.g., Kan et al., 2008), we examined the DT of two offspring by mothers and by fathers. This involved taking into account information about multiple dyadic relationships, including mother-child relationships with two offspring, father-child relationships with two offspring, and mother-father dynamics in an effort to capture family system dynamics. As we elaborate below, previous work suggests that mothers and fathers who are similar in their DT of offspring are coordinated in their parenting, whereas incongruence between mothers’ and fathers’ DT may indicate problems in the coparenting alliance (Reiss et al., 1994).

Cultural Values and Practices in Coparenting

A limitation of research on coparenting is its lack of attention to ethnic minority families. Culture is multidimensional, involving (subjective) values and observable practices (Cabassa, 2003), both of which play a role in socialization (Buriel, 1993; Parke et al., 2004). When culture is a focus, most studies test between-group differences (e.g., Mexican-origin versus Anglo) and rely on proxy markers of culture, such as language, ethnicity, or nativity. These status variables, however, provide no insights into the cultural processes underlying variations in family and youth functioning within a cultural group (McLoyd, 1998). Accordingly, we assessed cultural values and practices in an effort to illuminate the role of culture in coparenting dynamics.

A key Latino cultural value is familism, which reflects family cohesion, obligations and interdependence (Cauce & Domenech-Rodriguez, 2002; Sabogal, Marin, Otero-Sabogal, Vanoss Marin, & Perez-Stable, 1987). Theoretically, we expected strong familism values to be linked with positive coparenting practices, given that familism values emphasize cooperation and interparental support. Familism values have been invoked to explain coparenting dynamics such as joint decision making in Mexican-origin families (e.g., Caldera, Fitzpatrick, & Wampler, 2002); however, no studies have measured variations in parents’ familism values and directly tested the links between familism values and coparenting. Based on prior work, we predicted that parents with stronger familism values would exhibit more similar DT toward offspring.

Mexican-origin families are not rigidly stereotypical (Caldera et al., 2002), but gender is an organizing feature of family roles and responsibilities in Mexican culture (Cauce & Domenech-Rodriguez, 2002). This organization prescribes different roles for mothers and fathers, with mothers assuming caregiving responsibilities and fathers serving as providers and disciplinarians. Prior work shows that parents’ gender role attitudes are linked to their parenting practices; for example, more traditional fathers were less involved in caregiving than fathers with more egalitarian gender role attitudes (Coltrane, Parke, & Adams, 2004). No studies have tested the link between parents’ gender role attitudes and coparenting, and the underlying mechanisms are not clear: Gender differentiated parenting roles may give rise to a division of labor that leads parents to favor same gender offspring and thus to be incongruent in their treatment of offspring, but traditional attitudes also may promote coparenting coordination, such as when fathers defer to mothers on parenting decisions. This study explores these two possibilities.

Research suggests that cultural practices also shape parenting (Buriel, 1993; Parke et al., 2004), but researchers have not yet tested the role of cultural practices in coparenting. Some argue that involvement in Anglo culture may disrupt the traditional balance of parenting responsibilities for mothers and fathers (Parke et al.), a process that could lead to coparenting problems. Consistent with this idea, we predicted that parents who were relatively more Anglo-than Mexican-oriented in their cultural practices would exhibit incongruence in DT.

Links between Coparenting, Marital Quality, and Adolescent Adjustment

Previous research on coparenting, as measured by interparental congruence in DT, suggests that discrepancies between mothers and fathers have negative implications for marital quality and youth well-being (e.g., McHale et al., 1995; Volling & Elins, 1998). A family systems perspective provides insight into the underlying processes. Ideally, subsystems within the family are defined by boundaries which are clear enough for subsystems to function properly, but also flexible enough to allow for contact between subsystems (Minuchin, 1974). Ineffective boundary maintenance, in the form of weak marital ties and/or parent-child coalitions, is seen in distressed families and thought to be a sign of dysfunctional relationships (Gilbert, Christensen, & Margolin, 1984; Minuchin). Prior work suggests that parental incongruence in DT is a sign of a parent-offspring coalition that emerges in a distressed marital relationship: while one parent treats both offspring equally, the other parent favors a one child, turning to the child rather than the spouse for fulfillment (Minuchin; Reiss et al., 1994). Such a parent-child alliance may in turn undermine the marital bond and lead to increased marital disharmony (Gilbert et al.).

Parental incongruence also may have implications for children’s adjustment through triangulation, a process in which parents engage their children in marital conflict and encourage them to take sides (Minuchin, 1974). Offspring who experience distress at their level of intimacy with a parent or who are caught in the middle of marital problems may respond by acting out or developing internalizing symptoms (Franck & Buehler, 2007; Sabatelli & Anderson, 1991). Mothers and fathers both treating their children similarly, in contrast, reflects parental teamwork, support for one another’s child rearing efforts, and an ability to uphold appropriate boundaries between the marital and parent-child subsystems.

Most research on links between coparenting, marital quality, and youth adjustment has studied European Americans, and an important question is whether findings hold up in other ethnic groups. Some studies suggest that effective coparenting has universal implications (Lindahl, Malik, Kaczynski, & Simons, 2004), whereas others hypothesize that coparenting may have different effects in Mexican-origin families given the emphasis on family solidarity and cohesion (Parke et al., 2004). Further, coparenting research has focused on parents raising young children and less is known about coparenting in adolescence (for exceptions, see Baril et al., 2007; Feinberg et al., 2007). Coparenting issues may be salient during adolescence, as youth strive for independence and mothers and fathers are faced with new parenting challenges that tax their ability to present a united front. Thus, our third aim was to replicate findings of links between interparental incongruence and marital difficulties and adolescent adjustment problems.

Summary of Study Goals and Hypotheses

Our goals were to (1) describe patterns of DT in a sample of Mexican-origin families; (2) examine the links between these patterns and cultural values and practices; and (3) replicate previous studies showing that DT incongruence is associated with marital and youth adjustment problems. We predicted that interparental incongruence would be associated with weaker familism values, relatively stronger orientations to Anglo than Mexican culture, and poorer marital and youth adjustment. Conversely, we expected that parents who were similar in DT would exhibit stronger familism values, stronger orientations to Mexican relative to Anglo culture, and fewer marital and youth adjustment problems. Given the lack of scholarly work on gender role attitudes, our analyses here were exploratory.

Method

Participants

The data came from a study of family socialization and adolescent development in Mexican-origin families (Updegraff, McHale, Whiteman, Thayer, & Delgado, 2005). The 246 participating families were recruited through schools from a southwestern city. Given the larger study’s goals, criteria for participation were: (1) mothers were of Mexican origin; (2) a 7th grader and an older sibling were living at home and not learning disabled; (3) biological mothers and biological or long-term adoptive fathers were living at home (all non-biological fathers had been in the home for a minimum of 10 years); and (4) fathers worked at least 20 hours/week. Although not a criteria for participation, most fathers (93%) also were of Mexican origin. Recruitment letters describing the study in both English and Spanish were sent to families and follow-up telephone calls were made by bilingual staff to determine eligibility and interest.

Families’ names were obtained from junior high schools in five school districts and five parochial schools. Of those who were eligible, 284 (67%) agreed to participate. Interviews were completed by 246 families (see Updegraff et al., 2005 for details about the sampling procedure). Two families were missing data on parental DT and one family was missing data on the other variables of interest, resulting in a final sample of 243 families. Families represented a range of education and income levels. Median family income was $40,400 (for two parents and an average of 3.72 children, range 2 to 9) and 18.3% of families met federal poverty guidelines, a figure similar to the county from which the sample was drawn (18.6%; US Census Bureau, 2000). Mothers and fathers had completed an average of 10 years of education (mothers: M = 10.38, SD = 3.72; fathers: M = 9.91, SD = 4.36). Mexico-born mothers and fathers had lived in the U.S. for 12.44 (SD = 8.84) and 15.10 (SD = 8.73) years, and 66% of mothers and 68% of fathers chose to complete their interviews in Spanish. Average marital duration was 17.49 years (SD = 5.27). Older siblings were 15.70 (SD = 1.55) and younger siblings were 12.77 (SD = .58) years old and about half of the adolescent sample was male.

Procedures

Data were collected during home interviews lasting two to three hours. Interviews were conducted individually by bilingual interviewers using laptop computers and questions were read aloud to participants. Families were paid a $100 honorarium.

Measures

All measures were forward- and back-translated for local Mexican dialect. A third Mexican American translator reviewed all measures and discrepancies were resolved.

Parental differential treatment

Mothers and fathers reported on their differential affection and discipline toward their two offspring over the past year using an adapted version of the Sibling Inventory of Differential Experience (SIDE, Daniels & Plomin, 1985). The two items used in this study were “Whom would you say you were usually nicer or more affectionate towards?” and “Whom did you discipline more?” Each parent responded using a 5-point scale (1 = younger child a lot more; 2 = younger child a little more; 3 = both children the same; 4 = older child a little more; 5 = older child a lot more). Consistent with prior work (McHale et al., 1995), we combined categories 1 and 2, and 4 and 5 so the final scale had three possible values (i.e., 1 = younger child more; 2 = both children the same; 3 = older child more).

Cultural values and practices

Mothers and fathers reported on their familism values using a 16-item subscale of the Mexican American Cultural Values Scale for Adolescents and Adults (Knight et al., 2010) on which they used a response scale ranging from 1 (strongly disagree) to 5 (strongly agree) to rate items such as, “Family provides a sense of security because they will always be there for you.” Parents rated their traditional gender role attitudes on a 10-item scale adapted from Hoffman and Kloska (1995). Responding to items such as, “A husband’s job is more important than a wife’s,” they used a scale from 1 (strongly agree) to 4 (strongly disagree). Using the 30-item Acculturation Rating Scale for Mexican Americans-II (ARSMA-II; Cuellar, Arnold, & Maldonado, 1995), mothers and fathers reported on their orientations to Mexican culture (e.g., “My family cooks Mexican food”) and Anglo culture (e.g., “My friends are of Anglo origin”) on a 5-point scale (1 = not at all, 5 = extremely often or almost always). Given that scores on the Mexican and Anglo cultural orientation subscales were highly correlated, r (243) = −.52, p < .001 for mothers and r (243) = −.57, p < .001 for fathers, and consistent with prior work (e.g., Parke et al., 2004) Mexican orientation was subtracted from Anglo orientation to obtain a single score for cultural orientation, with higher values indicating relatively stronger orientations toward Anglo than to Mexican culture. Cronbach’s alphas for mothers and fathers on all measures of cultural values and practices were above .80. Correlations between the three measures of culture ranged from r (243) = −.46, p < .001 (mothers’ traditional gender attitudes and cultural orientations) to r (243) = .35, p < .001 (mothers’ familism values and traditional gender attitudes), suggesting that they represented unique constructs.

Marital adjustment

Coparenting satisfaction was measured using a 5- item index of marital satisfaction (Huston, McHale, & Crouter, 1986). Mothers and fathers used a scale ranging from 1 (extremely dissatisfied) to 9 (extremely satisfied) to rate items such as, “How satisfied are you with the extent to which you and your husband/wife agree on important child-rearing decisions?” Cronbach alphas were above .89. Parents reported on marital love and marital conflict (Braiker & Kelley, 1979) using a 9-point scale (1 = not at all; 9 = very much) scale. Example items were “To what extent do you have a sense of “belonging” with your husband/wife?” (love; 9 items) and “How often do you feel angry or resentful toward your husband/wife?” (conflict; 5 items). Cronbach’s alphas were .84 and .88 for mothers and fathers on the love scale and .67 for both parents on the conflict scale. Because the marital love scores were negatively skewed for both parents, the distributions were first reflected, a natural log transformation was performed, and the resulting distributions were reflected again to restore the original direction of the scale. Correlations between the marriage measures ranged from r (243) = .11, ns (fathers’ conflict and coparenting satisfaction) to r (243) = −.54, p < .001 (mothers’ love and coparenting satisfaction), suggesting that they indexed different constructs.

Youth adjustment

Adolescents reported on their involvement in risky behavior using a 24-item index (Eccles & Barber, 1990) on which they rated items such as skipping a day of school or getting high or drunk on a 4-point scale (1 = never; 4 = more than 10 times). A natural log transformation was applied to correct for positive skew. Youth reported on their depressive symptoms in the past month using the 20-item Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). Responses to questions such as “I had crying spells” and “I felt depressed,” were rated on a scale of 1 (rarely or none of the time) to 4 (most of the time). Cronbach’s alphas ranged from .85 to .92, and correlations between risky behavior and depressive symptoms were r (243) = .34, p < .001 and r (243) = .52, p < .001 for older and younger siblings, respectively.

Results

Identifying Patterns of Differential Treatment

To describe interparental patterns of DT in affection and discipline, we first categorized mothers and fathers independently into one of three DT groups based on their responses on the SIDE. Most parents (77% of mothers and 81% of fathers) reported equal affection for their offspring. Younger siblings were favored with more affection than their older siblings by 13% of mothers and 14% of fathers. There was more variation in the discipline domain: 54% of mothers and 60% of fathers reported disciplining both siblings equally and 30% of mothers and 21% of fathers reported directing more discipline toward the younger sibling. Chi-squared analyses revealed no significant effects for youth sex or dyad sex composition on any of the DT measures.

To move to the family level and examine interparental patterns of DT, families were classified using a method applied in previous research (e.g., McHale et al., 1995; Volling & Elins, 1998). We crossed mothers’ and fathers’ reports of DT in each domain, which resulted in nine possible groups (see Table 1). Given that theory and prior research suggested no hypotheses about birth order differences, groups characterized by favoritism toward older and younger siblings were combined to yield four patterns: (1) mothers and fathers treated both offspring equally (“equal” treatment group); (2) one parent favored either the older or younger offspring and the other parent treated both offspring equally (“incongruent” treatment group); (3) both parents favored the same offspring (“congruent” treatment group); or (4) one parent favored one offspring and the other parent favored the other offspring (“complementary” group).

Table 1.

Correspondence Between Mothers’ and Fathers’ Reports of Differential Affection and Discipline, Ns (and Percentages; N = 243 Families)

Mothers’ Reports Fathers’ Reports
Younger sibling more Equal treatment Older sibling more
Affection
 Younger sibling more 4 (2) 28 (12) 0 (0)
 Equal treatment 25 (10) 156 (64) 7 (3)
 Older sibling more 5 (2) 12 (5) 6 (2)
Discipline
 Younger sibling more 22 (9) 45 (19) 7 (3)
 Equal treatment 24 (10) 83 (34) 23 (9)
 Older sibling more 5 (2) 17 (7) 17 (7)

Note. Incongruent patterns of differential treatment are in boldface, congruent patterns are underlined, and complementary patterns are italicized.

Table 1 shows that, for affection, both mothers and fathers in 156 families reported treating their offspring equally, in 72 families (30% of the sample), an incongruent pattern emerged, and the congruent (n = 10) and complementary patterns (n = 5) were rare. For discipline, only 34% of families fell into the equal group and the largest group was the incongruent group with 45% of the sample (n = 109). The congruent group contained 39 families, and as with affection, the complementary pattern for discipline rarely emerged (n = 12).

In the subsequent analyses, following prior work we determined which groups to compare based on cell size and conceptual interest. In the affection domain we focused on equal versus incongruent group comparisons, and for the discipline domain we compared the equal, incongruent, and congruent groups. Given the rarity of the complementary pattern in both domains and the congruent pattern in the affection domain, these families were excluded from further analyses. We ran all models with parent-child warmth as a control variable to test for the effects of differential parent-child relationships over and above the absolute level of parent-child relationship quality; this did not substantially change the results, so for reasons of parsimony, parent-child warmth was not included in the final models.

Cultural Correlates of Differential Treatment Patterns

To address our second and third research goals, we used a series of 2 (DT group: equal vs incongruent) × 2 (respondent: mother vs father or older vs younger sibling depending on the dependent variable) mixed model ANOVAs for the affection domain and 3 (DT group: equal, incongruent, or congruent) × 2 (respondent) mixed model ANOVAs for the discipline domain, with respondent as the within-groups factor. The “respondent” factor depended on which family members reported on the dependent variable: We examined mother versus father reports of the cultural variables and marital adjustment, and older versus younger siblings’ reports of the adjustment indices. We did not have hypotheses about group X respondent interactions, but these were included to ascertain whether group effects differed across family members. Because significant interactions emerged in only two cases, they are described in the text, and given our study goals we focused on the main effects of DT group as shown in Table 2.

Table 2.

Mean Affection and Discipline Group Differences (and SDs) for Cultural Correlates, Marital Quality, and Youth Adjustment

Affection Discipline

Equal (n = 156) Incongruent (n = 72) Equal (n = 83) Incongruent (n = 109) Congruent (n = 39)
Familism values 4.49 (0.31) a 4.34 (0.31) b 4.54 (0.27) x 4.37 (0.35) y 4.34 (0.32) y
Traditional gender role attitudes 2.13 (0.50) a 1.87 (0.47) b 2.15 (0.52) x 2.04 (0.49) x 1.79 (0.44) y
Cultural orientation −1.40 (1.17) a −0.42 (1.52) b −1.66 (1.08) x −0.86 (1.37) y −0.24 (1.41) z
Coparenting satisfaction 7.53 (1.25) a 7.17 (1.28) b 7.58 (1.35) 7.22 (1.32) 7.37 (1.18)
Marital love 2.58 (0.38) a 2.45 (0.39) b 2.59 (0.38) x 2.46 (0.41) y 2.55 (0.35) x y
Marital conflict 4.13 (1.40) 4.36 (1.26) 3.97 (1.43) 4.38 (1.39) 4.16 (1.03)
Youth risky behavior 1 0.31 (0.20) 0.33 (0.19) 0.28 (0.19) x 0.36 (0.22) y 0.30 (0.16) x y
Youth depressive symptoms 1 1.85 (0.36) 1.82 (0.36) 1.78 (0.32) x 1.92 (0.39) y 1.75 (0.34) x y
Parent education 9.45 (3.58) a 11.38 (3.46) b 8.59 (3.58) x 10.34 (3.42) y 12.54 (2.81) z
Age spacing 2.72 (1.55) a 3.38 (1.59) b 2.88 (1.48) x y 2.72 (1.57) x 3.51 (1.73) y

Note. Means in the same row with different subscripts are significantly different from each other (a, b are affection comparisons; x, y, z are discipline comparisons; p < .05).

1

Youth adjustment models included the older sibling’s age and both siblings’ genders as covariates.

Control Variables

As a preliminary step, we examined associations between DT groups and family background characteristics including the sex composition of the sibling dyad (same versus mixed), age spacing between the two siblings, family size, and parent education. These analyses revealed significant effects only for age spacing and parent education: Parents who had more education and families with a larger age gap between siblings were more likely to exhibit incongruent than equal patterns of affection (see Table 2); F (1, 226) = 14.43, p < .001 for education, F (1, 226) = 8.73, p < .01 for age spacing, and more likely to show congruent than incongruent or equal discipline patterns, F (2, 228) = 18.66, p < .001 for education, F (2, 228) = 3.65, p < .05 for age spacing.

Cultural values and practices

As hypothesized, significant DT group effects with Tukey follow-up tests for the discipline comparisons, showed that parents in the equal affection and discipline groups reported stronger familism values than parents in the incongruent and congruent groups, F (1, 226) = 11.73, p < .001 for affection and F (2, 228) = 8.58, p < .001 for discipline. A significant DT group X parent interaction emerged for affection, F (1, 226) = 5.74, p = .02. Follow-up tests indicated that fathers in the equal affection group reported stronger familism values (M = 4.54, SD = 0.39) than fathers in the incongruent group (M = 4.30, SD = 0.40). Mothers showed a similar pattern (M = 4.44, SD = 0.41 for the equal group; M = 4.38, SD = 0.39 for the incongruent group), but follow-up tests did not reach statistical significance.

The models for traditional gender role attitudes also revealed a significant DT group effect for affection, with parents in the equal group reporting more traditional attitudes than parents in the incongruent group, F (1, 226) = 14.24, p < .001. For discipline, a significant DT group effect revealed that congruent parents reported significantly more egalitarian gender role attitudes than did those in both the equal and incongruent groups, F (2, 228) = 7.06, p < .001.

The results for parents’ cultural orientations revealed a significant main effect for differential affection group, F (1, 226) = 27.94, p < .001. As hypothesized, parents in the equal group reported relatively stronger Mexican than Anglo cultural orientations as compared to those in the incongruent group. Turning to discipline, a main effect for group, F (2, 228) = 18.48, p < .001, and follow-up tests revealed that all three groups were significantly different in their cultural orientations: Parents in the equal group scored the highest in their orientations to Mexican relative to Anglo culture, followed by those in the incongruent group, and then the congruent group, F (2, 228) = 18.48, p < .001.

Marital and Youth Adjustment Correlates of Differential Treatment Patterns

Our third goal was to replicate previous research linking patterns of interparental incongruence to marital and youth adjustment problems. Results are shown in Table 2.

Marital Adjustment

The results for the affection model revealed a DT main effect for coparenting satisfaction, F (1, 226) = 4.02, p = .05. As hypothesized, parents who exhibited equal patterns of affection also reported higher levels of satisfaction with their coparenting relationship. There were no significant group differences for differential discipline.

The results for marital love were also consistent with our hypotheses: Mothers and fathers who exhibited equal affection and discipline patterns reported more love than those in the incongruent groups, F (1, 226) = 4.92, p = .03 for affection and F (2, 228) = 3.06, p = .05 for discipline. A significant group X parent interaction emerged for discipline, F (2, 228) = 3.36, p = .04, however. Mothers in the equal and congruent discipline groups reported more love (M = 2.46, SD = 0.44; M = 2.52, SD = 0.42) than those in the incongruent group (M = 2.30, SD = 0.50). Although group differences were not significant for fathers’ love, fathers in the equal group reported the highest levels of love (M = 2.73, SD = 0.46), followed by the incongruent (M = 2.61, SD = 0.46) and congruent (M = 2.59, SD = 0.42) groups. Finally, there were no group differences in marital conflict for either differential affection or differential discipline.

We conducted follow-up analyses with incongruent and congruent families to test whether these effects varied by which parent (mother or father) engaged in favoritism and which youth (older or younger sibling) received favorable treatment. To test for parent differences, we created two groups of incongruent families: one where mothers showed more affection or discipline to one sibling and fathers treated both siblings equally, and one where fathers showed more affection or discipline to one sibling and mothers treated both equally. Then, we used this grouping variable in the same mixed model ANOVA framework to predict marital adjustment. To test for sibling differences, we again re-grouped incongruent families into two groups: one where one parent favored the older sibling and the other parent treated them both equally, and a second group where one parent favored the younger sibling and the other parent treated them both equally. For the families in the congruent discipline group, we followed up by creating two groups: one where the older sibling received more discipline from both parents and one where the younger sibling received more discipline from both parents. Consistent with Kan et al. (2008), we found no systematic differences in any of these comparisons and the number of statistically significant effects was smaller than chance; in other words, the links between incongruent parenting and marital adjustment did not differ depending on which parent engaged in preferential treatment or whether it was the older or younger sibling who was preferred.

Youth Adjustment

Given developmental and gender differences in risky behaviors and depressive symptoms (e.g., Steinberg & Morris, 2001), older siblings’ age and both siblings’ genders were included as covariates in the models for youth adjustment. Due to our eligibility criteria, there was a larger age range for older (SD = 1.55 years) than for younger (SD = 0.58 years) siblings, so we controlled only for the older sibling’s age. For differential affection, there were no group differences for risky behaviors or depressive symptoms. Significant differences emerged in the differential discipline models, however. Consistent with previous research (e.g., McHale et al., 1995), youth whose parents exhibited incongruent treatment reported more risky behaviors than youth with parents who treated both siblings equally, F (2, 225) = 4.68, p = .01. Similarly, youth whose parents were incongruent in the discipline domain reported more depressive symptoms than in the equal group, F (2, 225) = 4.81, p = .01.

We conducted the same series of follow-up analyses for adjustment problems that we used with the marriage measures. Only one follow-up was significant: In the congruent discipline group, adolescents who experienced relatively more discipline from both parents reported higher levels of risky behavior, F (1, 34) = 4.24, p = .05 for older siblings (for these logged scores, M = 0.44, SD = 0.23 for siblings who received relatively more discipline; M = 0.29, SD = 0.19 for those who received relatively less discipline) and F (1, 34) = 5.11, p = .03 for younger siblings (M = 0.35, SD = 0.21 for siblings who received relatively more discipline; M = 0.20, SD = 0.16 for those who received relatively less discipline). In contrast, youth from incongruent families reported more risky behavior than youth in equal treatment families, regardless of which sibling received more discipline or whether it was the mother or the father who engaged in differential discipline. Importantly, this pattern suggests that even youth who received less discipline than their sibling showed poorer adjustment when their parents were not on the same page, underscoring the systemic nature of coparenting processes.

Discussion

The findings of this study are consistent with a family systems perspective and suggest that the patterning of mothers’ and fathers’ DT is linked to cultural values and practices and has implications for both marital relationships and youth adjustment problems. This study adds to the literature by exploring systems dynamics in a sample of Mexican-origin families raising adolescents. Below we review the findings in light of earlier research, highlighting ways in which our research advances understanding of coparenting processes and family systems dynamics, more generally.

Identifying Coparenting Patterns

Our approach to measuring coparenting was based on a family systems view and took into account multiple family members’ experiences. Consistent with research on European American families (McHale et al., 1995; Volling & Elins, 1998), most parents reported treating their children equally, especially in the affection domain. A substantial number of families, however, showed patterns indicative of potentially problematic coparenting in both affection and discipline: We found evidence of an incongruent pattern, wherein one parent directed more of a given form of treatment toward one offspring while the other parent treated both offspring equally, and a congruent pattern wherein both parents directed relatively more discipline toward one offspring than the other. Despite the important role of gender in guiding roles and responsibilities in Mexican-origin families (Cauce & Domenech-Rodriguez, 2002) but consistent with research on European American families (McHale et al., 1995; Volling & Elins, 1998), we found no evidence for a pattern of mothers favoring their daughters and fathers favoring their sons. We used parent reports of DT, but some research suggests that parents and their children may not agree about parents’ DT (Kowal, Krull, & Kramer, 2006) and a fruitful research direction would be to examine siblings’ perspectives on their parents’ DT patterns.

Cultural Correlates of Interparental Patterns

The foremost contribution of this study was to identify the cultural correlates of interparental patterns of DT. This work highlights the role of Mexican values in positive family dynamics and has implications for culturally sensitive interventions with this population. Given the strong emphasis on family unity in traditional Mexican culture (Cauce & Domenech-Rodriguez, 2002; Sabogal et al., 1987), we expected that parents with stronger ties to Mexican culture would be most likely to exhibit an equal pattern of treatment, the pattern that reflects parents being on the same page and working toward similar parenting goals (Kan et al., 2008). Consistent with our predictions, parents with an equal pattern of discipline reported higher levels of familism values, and the same was true for fathers in the equal affection group. A key component of familism values is putting the family’s needs above those of the individual and working together to promote family harmony. Mothers and fathers who strongly endorse these principles may be more likely to coordinate their parenting in order to preserve family unity, and equal treatment of offspring may be one component of achieving this goal (Caldera et al., 2002).

The findings for cultural practices aligned with those for familism values. Parents with stronger Mexican cultural orientations were most likely to report an equal pattern of treatment. The most Anglo-oriented parents, in contrast, were more likely to show the congruent pattern wherein both mothers and fathers disciplined the same offspring more than his or her sibling. More so than Mexican culture, Anglo culture places an emphasis on individual achievement (Knight et al., 2010), and Anglo-oriented parents may be inclined to treat their children differently if they feel it is necessary for their children to succeed. In contrast, Mexican-oriented parents may place a higher value on solidarity, treating all of their children equally to promote family cohesion, rather than singling out one offspring for extra discipline or affection.

Our examination of gender role attitudes as a correlate of DT patterns was more exploratory. We suggested that traditional gender role attitudes might be conducive to a strong coparenting relationship, for example, if fathers deferred to mothers on childrearing decisions and followed the mothers’ lead. In this scenario, mothers and fathers would show coordinated parenting (Caldera et al., 2002). A pattern consistent with this idea emerged: Parents who reported more traditional attitudes were most likely to display the equal pattern of interparental treatment, while mothers and fathers with more egalitarian values reported incongruent affection and congruent discipline. Endorsing less gender-stereotyped parenting roles could create disagreements over childrearing responsibilities, especially if one parent is less traditional than the other, and result in incongruence between mothers and fathers. These findings are some of the first on the role of gender dynamics in coparenting, and this topic clearly merits further study.

Importantly, the cultural values and practices measured here were moderately correlated with one another, suggesting that although they tap into unique constructs, they also cohere in predictable patterns. Parents’ education level is another integral part of the cultural package, and as a control variable, was associated with interparental patterns of DT. The equal groups included the least educated parents, whereas the most highly educated parents were in the congruent discipline and incongruent affection groups. Taken together, these findings suggest that achievement related pressures and goals may promote parents’ DT of offspring, but more research is needed to explore this possibility.

Marital and Youth Adjustment

Our final goal was to replicate findings of links between interparental DT patterns and marital and youth adjustment. Our contention was that interparental patterns serve as indices of coparenting in that they reflect the extent to which mothers and fathers are on the same page. Consistent with research on European American families (McHale et al., 1995; Volling & Elins, 1998), mothers and fathers who showed an equal pattern of treatment reported more marital love and, in the case of affection, more satisfaction with their coparenting relationship as compared to incongruent parents. These findings support the idea that an incongruent pattern may be a sign of problematic boundary maintenance or a poor coparenting alliance. Previous research using more traditional measures of coparenting has established links between coparenting problems and less positive marital relationships (e.g., Schoppe-Sullivan et al., 2004). In the case of differential affection, interparental incongruence might also indicate a coalition between one of the parent-child dyads. These findings are relevant for practice and underscore the potential utility of targeting the coparenting relationship as a way to improve both parent and youth adjustment.

Also consistent with research showing that poor coparenting is associated with youth adjustment problems (Baril et al., 2007; Feinberg et al., 2007), we found that youth with parents who were incongruent in their differential discipline showed more risky behaviors and depressive symptoms compared to those whose parents exhibited an equal treatment pattern. Importantly, it did not matter which sibling received more discipline – both offspring, not just the one who was disciplined more, showed poorer adjustment when their parents were incongruent, and the effects of DT were evident beyond the effects of average parental warmth. These findings are consistent with a family systems view and suggest that inconsistency between mothers and fathers spills over to impact both children in a negative way. Follow-up tests focused on the congruent group in which both parents disciplined the same offspring more often revealed that the targeted offspring reported higher levels of risky behavior than his or her sibling, a pattern also reported by Volling and Elins (1998) in families with preschool children. This pattern could be evidence of a child effect, wherein parents respond to their child’s behavior problems by disciplining him or her more. More work is needed here, however, to tease apart direction of effect and expose the processes underlying these associations.

We expected that patterns of differential affection also would be associated with variations in youth adjustment. No group differences emerged, however, which is consistent with some past work (Volling & Elins, 1998). One possible reason for these null findings is the limited variability in the differential affection groups. Nearly two thirds of the parents treated their offspring equally in the affection domain, resulting in smaller groups for comparison. In contrast, only about one third of parents fell into the equal discipline group. Adolescence is a time when many youth experience a rise in internalizing symptoms and experiment with rule breaking, substance use, and other risky behaviors. In struggling to adjust to these changes, mothers and fathers may differ in how they evaluate and respond to their offspring (Feinberg et al., 2007). In this way, interparental incongruence may be both a cause and consequence of the emotional and behavioral changes in adolescence. Regardless of the direction of effect, these results are consistent with prior findings that, when mothers and fathers do not have a cohesive discipline strategy, adolescents are likely to experience adjustment problems.

Results relating to the congruent discipline group underscore the role of adolescents in their parents’ socialization activities and the complexity of family system dynamics. Mothers and fathers who both direct more discipline toward the same offspring are clearly on the same page, a positive family dynamic, and one linked to more marital love by mothers in this study. At the same time, DT may have negative implications for a disfavored child. These competing dynamics – positive coparenting in the context of preferential treatment of one child – remind us of the challenges parents face in balancing the needs and interests of different family members.

Conclusions

Our conclusions should be understood in light of the limitations of this study. First, although our sample was representative of the local population from which it was drawn, it was relatively small and not nationally representative. Future research should examine coparenting dynamics in samples that include more diverse families and a greater range of Latino cultures. Additionally, as we have noted, no conclusions about the direction of causality can be reached due to our cross sectional and correlational design. Longitudinal studies are needed to track how these family system dynamics unfold over time.

Despite these limitations, the current study makes an important contribution to the literature by examining coparenting in Mexican-origin families, a growing but understudied population in the US. Our focus on families with adolescent-aged offspring builds on previous coparenting research that has primarily examined families raising young children, and our approach to measuring coparenting represents an important step toward moving beyond self-reported measures and capturing the systemic nature of coparenting processes. Studying this sample of Mexican-origin families, we also were able to replicate previous findings with European American families on links between interparental incongruence and marital and youth adjustment problems. The replication underscores the idea that the implications of coparenting are not culture-specific and that coparenting is a key dynamic in both European American and Mexican-origin families. Our findings on the role of cultural practices and values provide new insights into the conditions that underlie positive coparenting practices and suggest directions for research on other cultural groups as well as new insights for parenting programs.

Acknowledgments

We thank the participating families as well as the following schools and school districts: Osborn, Mesa, and Gilbert school districts, Willis Junior High School, Supai and Ingleside Middle Schools, and St. Catherine of Sienna, St. Gregory, St. Francis Xavier, St. Mary-Basha, and St. John Bosco Schools. We also thank Mark Roosa, Nancy Gonzales, Roger Millsap, Meilissa Delgado, Jennifer Kennedy, Lorey Wheeler, Devon Hageman, and Shawna Thayer for their help in conducting this study. This research was funded by NICHD (R0l-HD39666), Kimberly Updegraff, Principal Investigator and the Cowden Fund to the Department of Family and Human Development at ASU.

Footnotes

Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/fam

Contributor Information

Anna R. Solmeyer, Department of Human Development and Family Studies, Pennsylvania State University

Sarah E. Killoren, Department of Human Development and Family Studies, Colorado State University

Susan M. McHale, Department of Human Development and Family Studies, Pennsylvania State University

Kimberly A. Updegraff, Department of Family and Human Development, Arizona State University

References

  1. Baril ME, Crouter AC, McHale SM. Processes linking adolescent well-being, marital love, and coparenting. Journal of Family Psychology. 2007;21:645–654. doi: 10.1037/0893-3200.21.4.645. [DOI] [PubMed] [Google Scholar]
  2. Braiker HB, Kelley HH. Conflict in the development of close relationships. In: Burgess R, Huston T, editors. Social exchange in developing relationships. New York: Academic Press; 1979. pp. 135–168. [Google Scholar]
  3. Buriel R. Childrearing orientations in Mexican American families: The influence of generation and sociocultural factors. Journal of Marriage and Family. 1993;55:987–1000. doi: 10.2307/352778. [DOI] [Google Scholar]
  4. Cabassa LJ. Measuring acculturation: Where we are and where we need to go. Hispanic Journal of Behavioral Sciences. 2003;25:127–146. doi: 10.1177/0739986303025002001. [DOI] [Google Scholar]
  5. Caldera YM, Fitzpatrick J, Wampler KS. Coparenting in intact Mexican American families: Mothers’ and fathers’ perceptions. In: Contreras JM, Kerns KA, Neal-Barnett AM, editors. Latino children and families in the United States: Current research and future directions. Westport, CT: Praeger; 2002. pp. 107–132. [Google Scholar]
  6. Cauce AM, Domenech-Rodriguez M. Latino families: Myths and realities. In: Contreras JM, Kerns KA, Neal-Barnett AM, editors. Latino children and families in the United States: Current research and future directions. Westport, CT: Praeger; 2002. pp. 3–26. [Google Scholar]
  7. Coltrane S, Parke RD, Adams M. Complexity of father involvement in low income Mexican American families. Family Relations. 2004;53:179–189. doi: 10.1111/j.0022-2445.2004.00008.x. [DOI] [Google Scholar]
  8. Cuéllar I, Arnold B, Maldonado R. Acculturation Rating Scale for Mexican Americans-II: A revision of the original ARSMA scale. Hispanic Journal of Behavioral Sciences. 1995;17:275–304. doi: 10.1177/07399863950173001. [DOI] [Google Scholar]
  9. Daniels D, Plomin R. Differential experience of siblings in the same family. Developmental Psychology. 1985;21:747–760. doi: 10.1037/0012-1649.21.5.747. [DOI] [Google Scholar]
  10. Deal JE. Marital conflict and differential treatment of siblings. Family Process. 1996;35:333–346. doi: 10.1111/j.1545-5300.1996.00333.x. [DOI] [PubMed] [Google Scholar]
  11. Eccles JS, Barber B. The Risky Behavior Scale. Department of Psychology, University of Michigan; Ann Arbor, USA: 1990. Unpublished manuscript. [Google Scholar]
  12. Feinberg ME, Kan ML, Hetherington EM. The longitudinal influence of coparenting conflict on parental negativity and adolescent maladjustment. Journal of Marriage and Family. 2007;69:687–702. doi: 10.1111/j.1741-3737.2007.00400.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Franck KL, Buehler C. A family process model of marital hostility, parental depressive affect, and early adolescent problem behavior: The roles of triangulation and parental warmth. Journal of Family Psychology. 2007;21:614–625. doi: 10.1037/0893-3200.21.4.614. [DOI] [PubMed] [Google Scholar]
  14. García Coll CT, Crnic K, Lamberty G, Wasik BH, Jenkins R, Garcia HV, McAdoo HP. An integrative model for the study of developmental competencies in minority children. Child Development. 1996;67:1891–1914. doi: 10.2307/1131600. [DOI] [PubMed] [Google Scholar]
  15. Gilbert R, Christensen A, Margolin G. Patterns of alliance in nondistressed and multiproblem families. Family Process. 1984;23:75–87. doi: 10.1111/j.1545-5300.1984.00075.x. [DOI] [PubMed] [Google Scholar]
  16. Hoffman LW, Kloska DD. Parents’ gender-based attitudes toward marital roles and child rearing: Development and validity of new measures. Sex Roles. 1995;32:273–295. doi: 10.1007/BF01544598. [DOI] [Google Scholar]
  17. Huston TL, McHale SM, Crouter AC. When the honeymoon’s over: Changes in the marriage relationship over the first year. In: Gilmour R, Duck S, editors. The emerging field of personal relationships. Hillsdale, NJ: Erlbaum; 1986. pp. 109–132. [Google Scholar]
  18. Kan ML, McHale SM, Crouter AC. Interparental incongruence in differential treatment of adolescent siblings: Links with marital quality. Journal of Marriage and Family. 2008;70:466–479. doi: 10.1111/j.1741-3737.2008.00494.x. [DOI] [Google Scholar]
  19. Kowal AK, Krull JL, Kramer L. Shared understanding of parental differential treatment in families. Social Development. 2006;15:276–295. doi: 10.1111/j.1467-9507.2006.00341.x. [DOI] [Google Scholar]
  20. Knight GP, Gonzales NA, Saenz DS, Bonds DD, German M, Deardorff J, Updegraff KA. The Mexican American Cultural Values Scale for adolescents and adults. Journal of Early Adolescence. 2010;30:444–481. doi: 10.1177/0272431609338178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lindahl KM, Malik NM, Kaczynski K, Simons JS. Couple power dynamics, systemic family functioning, and child adjustment: A test of a mediational model in a multiethnic sample. Development and Psychopathology. 2004;16:609–630. doi: 10.1017/S0954579404004699. [DOI] [PubMed] [Google Scholar]
  22. McLoyd VC. Changing demographics in the American population: Implications for research on minority children and adolescents. In: McLoyd VC, Steinberg L, editors. Studying minority adolescents: Conceptual, methodological, and theoretical issues. Mahwah, NJ: Erlbaum; 1998. pp. 3–28. [Google Scholar]
  23. McHale JP, Kuersten-Hogan R, Lauretti A, Rasmussen JL. Parental reports of coparenting and observed coparenting behavior during the toddler period. Journal of Family Psychology. 2000;14:220–236. doi: 10.1037/0893-3200.14.2.220. [DOI] [PubMed] [Google Scholar]
  24. McHale SM, Crouter AC, McGuire SA, Updegraff KA. Congruence between mothers’ and fathers’ differential treatment of siblings: Links with family relations and children’s well-being. Child Development. 1995;66:116–128. doi: 10.2307/1131194. [DOI] [PubMed] [Google Scholar]
  25. Minuchin S. Families and family therapy. Cambridge, MA: Harvard University Press; 1974. [Google Scholar]
  26. O’Connor TG, Hetherington EM, Reiss D. Family systems and adolescent development: Shared and nonshared risk and protective factors in nondivorced and remarried families. Development and Psychopathology. 1998;10:353–375. doi: 10.1017/S0954579498001643. [DOI] [PubMed] [Google Scholar]
  27. Parke RD, Coltrane S, Duffy S, Buriel R, Dennis J, Powers J, Widaman KF. Economic stress, parenting, and child adjustment in Mexican American and European American families. Child Development. 2004;75:1613–1631. doi: 10.1111/j.1467-8624.2004.00807.x. [DOI] [PubMed] [Google Scholar]
  28. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385–401. doi: 10.1177/014662167700100306. [DOI] [Google Scholar]
  29. Reiss D, Plomin R, Hetherington EM, Howe C, Rovine M, Tryon A, Stanley M. The separate worlds of teenage siblings: An introduction to the study of the nonshared environment and adolescent development. In: Hetherington EM, Reiss D, Plomin R, editors. Separate social worlds of siblings: Importance of nonshared environment on development. Hillsdale, NJ: Erlbaum; 1994. pp. 63–110. [Google Scholar]
  30. Sabatelli RM, Anderson SA. Family system dynamics, peer relationships, and adolescents’ psychological adjustment. Family Relations. 1991;40:363–369. [Google Scholar]
  31. Sabogal F, Marin G, Otero-Sabogal R, Vanoss Marin B, Perez-Stable EJ. Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences. 1987;9:397–412. doi: 10.1177/07399863870094003. [DOI] [Google Scholar]
  32. Schoppe-Sullivan SJ, Mangelsdorf SC, Frosch CA, McHale JL. Associations between coparenting and marital behavior from infancy to the preschool years. Journal of Family Psychology. 2004;18:194–207. doi: 10.1037/0893-3200.18.1.194. [DOI] [PubMed] [Google Scholar]
  33. Shanahan L, McHale SM, Crouter AC, Osgood DW. Linkages between parents’ differential treatment, youth depressive symptoms, and sibling relationships. Journal of Marriage and Family. 2008;70:480–494. doi: 10.1111/j.1741-3737.2008.00495.x. [DOI] [Google Scholar]
  34. Spencer MB. Old issues and new theorizing about African-American youth: A phenomenological variant of ecological systems theory. In: Taylor RL, editor. African-American youth: Their social and economic status in the United States. Westport, CT: Praeger; 1995. pp. 37–69. [Google Scholar]
  35. Steinberg L, Morris AS. Adolescent development. Journal of Cognitive Education and Psychology. 2001;2:55–87. [Google Scholar]
  36. Updegraff KA, McHale SM, Whiteman SD, Thayer SM, Delgado MY. Adolescents’ sibling relationships in Mexican American families: Exploring the role of familism. Journal of Family Psychology. 2005;19:512–522. doi: 10.1037/0893-3200.19.4.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. U.S. Census Bureau. American FactFinder. 2000 Available at: http//:www.census.gov.
  38. U.S. Census Bureau News. Hispanic Heritage Month 2010. 2010 Available at: http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb10-ff17.html.
  39. Volling BL, Elins JL. Family relationships and children’s emotional adjustment as correlates of maternal and paternal differential treatment: A replication with toddler and preschool siblings. Child Development. 1998;69:1640–1656. doi: 10.2307/1132137. [DOI] [PubMed] [Google Scholar]

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