Relations between Remembered Childhood Parental Acceptance-Rejection, Current Fear of Intimacy, and Psychological Adjustment among Pakistani Adults

Intimacy refers to an individual’s emotionally close and deep personal relationship with a partner. This is a kind of attachment relationship characterized by mutual love, affection, care, concern, sense of happiness, well-being, and emotional security between intimate partners Khaleque [1]. An intimate partner is a significant other as well as an attachment figure Khaleque [2]. Some people may be afraid of forming intimacy with another individual for different reasons including childhood experiences of rejection by attachment figures, such as parental rejection Rohner [3]. According to interpersonal acceptance and rejection theory (IPAR Theory), fear of intimacy (FOI) refers to an individual’s anxiousness or reluctance of forming intimate relationship and disclosing or exchanging personal information, thoughts, and feelings with a significant other who is uniquely important to him/her Rohner [3]. Interpersonal acceptance-rejection theory is an evidencebased theory of socialization and life span development that attempts to predict and explain cross-cultural causes, correlates, and consequences of interpersonal acceptance-rejectionespecially parental acceptance-rejection [4]. Rejected individuals often anxiously construct mental images of personal relationships as being untrustworthy, unsafe, unpredictable, or hurtful, and they are likely to develop a fear of intimacy [5].


Introduction
Intimacy refers to an individual's emotionally close and deep personal relationship with a partner. This is a kind of attachment relationship characterized by mutual love, affection, care, concern, sense of happiness, well-being, and emotional security between intimate partners Khaleque [1]. An intimate partner is a significant other as well as an attachment figure Khaleque [2]. Some people may be afraid of forming intimacy with another individual for different reasons including childhood experiences of rejection by attachment figures, such as parental rejection Rohner [3]. According to interpersonal acceptance and rejection theory (IPAR Theory), fear of intimacy (FOI) refers to an individual's anxiousness or reluctance of forming intimate relationship and disclosing or exchanging personal information, thoughts, and feelings with a significant other who is uniquely important to him/her Rohner [3].
How to cite this article: Khaleque

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to be linked worldwide to the experience of parental rejection in childhood [6], interpersonal acceptance-rejection theory predicts that adults' (both men's and women's) remembrances of parental (both maternal and paternal) rejection in childhood are likely to be associated with the fear of intimacy in adulthood, as mediated by the adults' current level of psychological maladjustment including relationship anxiety [4].
Several studies showed that remembrances of parental acceptance and rejection in childhood independently predicted psychological adjustment of young adults [7,8] and a study on fear of intimacy in married adults [9] found that adults' remembrances of parental rejection in childhood independently predicted their psychological adjustment, relationship anxiety, and fear of intimacy in 13 countries of the world. Intimacy poses great risk for emotional injuries because it involves personal information that individual does not want to share publically [10]. Hook et al. [11] reported four specific components of intimacy---love and affection, personal validation, trust, and self-disclosure. Intimacy is a phenomenon that is both wanted and feared. People get involved in different kind of activities and techniques under different settings ranging from online dating services to religious groups with an objective to establish intimate relationship. Those who are seeking intimate relationships often worry and fear about the process and its possible outcomes [12]. Fear of intimacy is a subdued capacity of an individual to exchange thoughts and feelings of deeply personal nature with highly valued another person because of anxiety [13]. In 1984, Hatfield discussed the concept and its different components such as; cognitive component i.e. intimates' willingness to disclose their information with one another, emotional component which encompasses partners' deep care about one another in form of like and love, and physical component wherein intimates feel comfortable in close physical proximity.
A satisfied intimate relation stimulates creativity, productivity, emotional regulation including contentment and wellbeing, happiness and meaning in one's life [14]. The inability to form intimate relationships or fear of intimacy is associated with poor psychological adjustment, low level of wellbeing, low selfesteem, psychological distress, illness, and depression [11,13,15]. Researchers have found that fear of intimacy associated with several undesirable outcomes in adulthood. For example, fear of intimacy and intimacy deficits were associated with very serious issues like rape and child molestation [16], fear of intimacy was significantly correlated with marital dissatisfaction and this relationship was fully moderated by attachment styles like secure and insecure, indicating the importance of early childhood experience in the development of fear of intimacy [17].
In a study Phillips et al. [18] found that both maternal and paternal care were significantly associated with participants' reported fear of intimacy. In the same study, linear regression analysis revealed that parental care was a significant predictor of participants' fear of intimacy. Additionally, participants with two caring parents reported lowest levels of fear of intimacy as compared to participants with one caring parent and/or no caring parent. Other researchers also supported the importance of childhood maternal care in adults' current fear of intimacy [19].
From the reviewed literature, it appears that individuals' fear of intimacy in adulthood tends to be associated with their relationship patterns with parents during their childhood as construed in IPAR Theory. Although many studies explored relations between remembered childhood parental acceptancerejection, fear of intimacy, and psychological adjustment in adulthood, very few or none of these studies so far explored such relationships at different stages of adults' life. Therefore, the present study was conducted to examine if there are relations between remembered childhood parental acceptance-rejection, fear of intimacy, and psychological adjustment among Pakistani young, middle, and older adults.

Measures
Demographic Information Form: An adaptation of the Personal Information Form [20] was used to obtain demographic information of participants.
Adult Parental Acceptance-Rejection Questionnaire (PARQ): Father and Mother-Short Forms [20]. PARQ father and mother were used to assess participants perceived childhood parental acceptance-rejection in this study. Both the questionnaires are identical except that one is related to father and the other is related to mother. Both questionnaires assess four domains of parental acceptance and rejection such as warmth/affection (e.g. my father/mother said nice things about me), hostility/aggression (e.g. my father/mother said many unkind things to me), indifference/neglect (e.g. my father/mother paid no attention to me), and undifferentiated rejection (e.g. my father/mother seemed to dislike me). The items of the entire scales are rated on fourpoint Likert scale ranging from almost always true (4) to almost never true (1). Aggregate score on all the four subscales indicate parental acceptance and rejection in which a higher means lower acceptance and vice-versa. Mean coefficient alphas of the PARQ based on samples from 13 countries were .93 and .90 for mother and father versions, respectively [21]. In this study, the Cronbach's alphas were .82 for mother and .80 for father.

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Interpersonal Relationship Anxiety Questionnaire (IRAQ): IRAQ [22] was used in this study to assess participants' current level of interpersonal relationship anxiety. This questionnaire has nine words/phrases (e.g. stressed, scared etc.) to be rated on four-point Likert scale ranging from almost always true (4) to almost never true (1). Level of interpersonal relationship anxiety increases with the increase in score. The coefficient alpha for IRAQ ranged from .87 to .88 in several researches in different countries [23][24][25]. The coefficient alpha in this study was .78.

Adult Personality Assessment Questionnaire (PAQ) Short
Version: PAQ [20] was used to assess participants' current level of psychological mal/adjustment. This questionnaire has seven sub-scales including hostility/aggression (e.g. I feel resentment against people), dependency (e.g. I like my parents to give me a lot of attention), negative self-esteem (e.g. I get unhappy with myself), negative self-adequacy (e.g. I feel I cannot do things well), emotional unresponsiveness (e.g. I have difficulty showing people how I feel), emotional instability (e.g. I get upset when things go wrong), and negative worldview (e.g. I see life as full of dangers). The items of the entire scale are rated on four-point Likert scale ranging from almost always true (4) to almost never true (1). A higher total score in all seven sub-scales indicate lower psychological maladjustment and vice-versa. Findings of several studies shows that coefficient alpha for PAQ ranges from .81 to .91 [20,21]. In this study the Cronbach's alpha was .80.

Fear of Intimacy Scale (FIS):
The fear of intimacy scale [13] has 35 items to be rated on five-point Likert scale ranging from not at all true of me (1) to extremely true of me (5). This scale is administered to measure participants' fear of intimacy (e.g. I would feel comfortable keeping very personal information to myself,). Higher score indicates higher level of fear of intimacy and lower score indicates lower level of fear of intimacy. According to Descutner et al. [13] FIS has a good level of reliability and validity. In this study the coefficient alpha was .86.

Procedure
To collect the data for this study, the targeted participants were approached in different settings such as their homes, work places, educational institutions etc. After getting their consent the Urdu versions of above-mentioned scales were individually administered to the participants.

Results
As shown in Table 1, gender differences were significant for perceived maternal and paternal acceptance only for young adults. It revealed that young male adults perceived to be more rejected by their mother and father than female adults.  In the second step, participants from all three age groups were divided into two groups; first group labeled as accepted group. This group was constituted by participants whose score were less than midpoint on both PARQ mother and father versions and second group labeled as rejected group consisted of participants whose scores were on or above the midpoint on both PARQ mother and father versions Tables 2 & 3. Rejected participants (by both mother & father) from all three age groups reported higher levels of psychological maladjustment, interpersonal relationship anxiety, and fear of intimacy than accepted group, except older adults, where there were not significant differences in fear of intimacy between accepted and rejected participants by their father see (Tables 2 & 3). Maternal and paternal acceptance were significantly correlated with psychological adjustment, interpersonal relationship anxiety, and fear of intimacy for both males and females of all age groups except for older adults, where there were no significant correlations between paternal acceptance and fear of intimacy for both males and females and maternal acceptance and fear of intimacy only for females. (Tables 4-6). Psychological adjustment and interpersonal relationship anxiety were significantly correlated with fear of intimacy for respondents of both genders of all age groups except for female older adults, where there was not significant relationship between psychological adjustment and interpersonal relationship anxiety and fear of intimacy. Hierarchical regression analysis revealed that only paternal acceptance and psychological adjustment made significant independent contribution for the fear of intimacy of young and middle adults (Table 7).
Forty-five and forty-four percent of the variance in fear of intimacy were accounted for by these variables for young and middle adults respectively (Table 7). When psychological adjustment was entered as dependent variable, maternal acceptance made significant and independent contribution for the psychological adjustment of only young adults, paternal acceptance made significant and independent contribution for the psychological adjustment of young and older adults, and fear of intimacy made significant and independent contribution for the psychological adjustment of young and middle adults. (Table 8).  Along with other predictors maternal acceptance explained 31% variance for young adults' psychological adjustment, paternal acceptance along with other predictors explained 48% variance in psychological adjustment of older adults, and fear of intimacy along with other predictors explained 28% variance in psychological adjustment of middle adults (Table 8).

Discussion
The present study intended to test IPAR Theory's prediction that remembrances of parental rejection in childhood influence fear of intimacy and psychological adjustment in adulthood. Results showed that rejected adults (by both mother & father) reported higher level of fear of intimacy than did accepted adults in all age groups, except older adults. Hierarchical regression analysis revealed that only paternal acceptance and psychological adjustment made significant independent contributions for the fear of intimacy of young and middle adults. Two studies on Pakistani samples partially support our findings. For example, one study showed that married men's remembrances of paternal and maternal acceptance in childhood predicted their fear of intimacy but for women only maternal acceptance predicted their fear of intimacy [9]. Another study showed that remembrances of paternal acceptance in childhood and psychological adjustment predicted married women's fear of intimacy while remembrance of maternal acceptance in childhood and psychological adjustment predicted married men's fear of intimacy and maternal acceptance in childhood predicted unmarried men's fear of intimacy [26].
International literature in this field also supports findings of the present study. For example, in Greece, remembrances of parental (both maternal & paternal) acceptance in childhood predicted both men and women's fear of intimacy [27,28]. In Turkey, remembrance of maternal acceptance in childhood was significantly correlated with both men and women's fear of intimacy but paternal acceptance was significantly correlated only with men's fear of intimacy. Psychological adjustment of both men and women participants made a significant contribution to their fear of intimacy [29]. Remembrances of both maternal and paternal acceptance in childhood and current psychological adjustment contributed significantly to African American college students' fear of intimacy [30]. Childhood remembrances of paternal and maternal acceptance and current psychological adjustment made significant contribution to the fear of intimacy of Latino American university students [31]. Australian and Polish adults' remembrances of parental acceptance in childhood and current psychological adjustment were significantly correlated with their fear of intimacy [32]. In Portugal, only men's fear of intimacy was predicted by their remembrances of childhood maternal acceptance and women were less likely to suffer the negative consequences of parental rejection during childhood on their adulthood fear of intimacy [33]. Contradictory evidences reported by Glavak Tkalic et al. [34] from Croatia where parental acceptance in childhood failed to predict either men or women's fear of intimacy.
Additionally, the present findings showed that rejected adults (by both mother & father) reported higher levels of psychological maladjustment and interpersonal relationship anxiety than did accepted adults in all age groups, except older adults but maternal acceptance made significant and independent contribution for only young adults' psychological adjustment and paternal acceptance made significant independent contributions for young and older adults' psychological adjustment. We don't have any clear explanation why remembered childhood parental rejection are not significantly related with psychological maladjustment and interpersonal relationship anxiety of older adults. This may Further research is needed to find a clear answer to this question. However, past researchers reported consistent findings that remembrances of paternal and maternal acceptance in childhood predicted young adults' psychological adjustment [35], perceived paternal acceptance in childhood was a significant predictor of university students' psychological adjustment [7], maternal and paternal acceptance were significant predictors of school students' reported alexithymia [8], accepted children by their fathers and mothers reported higher level of psychological adjustment and lower level of misconduct as compared to those children who perceived to be rejected by their parents [36]. Studies on clinical population showed that paternal rejection in childhood has significant effects on depression, mania, and psychosis during adulthood [37]. In addition, maladjusted convicts were found to report experiences of parental rejection during childhood [38].
Cross-cultural research literature on this topic also supports findings of the present study. For example, remembrances of parental acceptance in childhood predicted current psychological adjustment in Turkey [39], Estonia [40], Bangladesh [41], India [42], and Kuwait [43]. Meta-analyses of cross-cultural and intracultural studies showed that parental acceptance during childhood has significant developmental outcomes during adolescence and adulthood including psychological maladjustment, and social, emotional, cognitive, and behavioral development, regardless of race, ethnicity, culture, gender, and geographical region of the world [44].
Furthermore, the present findings that male young adults perceived to be more rejected by their mother and father as compared to female young adults is consistently supported by several other studies. For example, more men than women, irrespective of their clinical status (clinical & non-clinical sample), reported to be rejected by their fathers than mothers during childhood [15,45] and more boys than girls reported to be rejected by their fathers [40,43].
To conclude, the findings of the present study seem to partially support the predictions of the IPAR Theory that childhood parental acceptance-rejection and psychological adjustment have significant contributions for the fear of intimacy of adults [46][47][48][49]. The findings of this study may be useful to the professionals and practitioners, who are concerned with the developmental outcomes of childhood parental acceptance and rejection on later development. We think that clinicians and counsellors who are concerned with the fear of intimacy and psychological maladjustment of adults should take into consideration, among others, their clients' childhood experiences of parental rejection. Having said this, we are also aware of some limitations of the present study such as data for the present study was based only on self-report from a small sample of a tribal subgroup with distinctly different sociocultural identity from the mainstream Pakistani society.