Investigation of the effect of somatization and anxiety development in the relationship of acceptance/rejection perceived by their fathers in early childhood in 18-65 years old people.

In this study, the relationship of perceived acceptance/rejection from the father with somatization and anxiety in early childhood was investigated. The study was carried out with 228 participants between the ages of 18-65. The scores obtained from the Demographic Information Form, Parental Acceptance Scale (Father form), Somatization Scale, Anxiety and Anxiety Scales obtained from the participants were analyzed with SPSS (Statistical Package Program for Social Science). In the study, a positive and significant relationship was found between the PARQ Father Form and its sub-dimensions warmth/affection (reverse coldness), neglect/indifference, hostility/aggression, undifferentiated rejection, and somatization and SAD. PARQ and somatization scores differed in demographic variables such as number of siblings, economic level, father’s education level, parental marital status, age; It was determined that the variables of number of siblings, parental marital status, father’s education level, and economic status differed for FAI. Neglect/indifference, hostility/aggression sub-dimensions were found to have important predictive roles on somatization and IAI. The negative effects of neglecting the father-child relationship for many years are seen in the literature. Studies should be carried out to explain the importance of fathers in early childhood, and preventive awareness training should be given at the same time.

Father’s love is associated with mental health in the process from childhood to adulthood. Father’s accepting/rejecting behaviors and children’s perception of these behaviors are affected by complex contexts such as social-cognitive learning, sociocultural, social and familial1 . Although the interculturally examined father-child relationship differs between different cultures, it is argued that fathers have an important role in the healthy development of children. Michael Lamb, the pioneer of father-child relationship research, speaks of the unfairness of the importance given to the influence of fathers on children’s development compared to mothers2. In Rohner’s research, while reaching the knowledge that the accepting relationship of the father is at least as important on the children as the mother’s; The negative effects of children who perceive rejection by their father may be more than the effects of mother rejection.

It is stated that spending positive time with the father contributes to the child’s social life and cognitive development processes, while at the same time he gains skills such as defining one’s own emotions and understanding the emotions of people in the outside world. When the universal needs of attention, love and trust are not adequately met between father and child, and when the sharing and expression of emotions are prevented, it can affect their psychological adjustment in adulthood. In the study, the relationship of paternal warmth dimension with somatization and anxiety was examined. In Ekar Theory, the warmth dimension of parenting consists of parental acceptance and rejection. The accepting dimension is the love and value given to the child, and paternal rejection refers to the absence of real or perceived warmth, care, and support. In the study, in which the father’s love was examined in terms of the development of the child within the framework of Rohner’s Parental Acceptance-Rejection Theory, it is stated that the behaviors related to the father’s love expressions have been neglected for many years compared to the mother’s love. Somatization is the tendency to communicate and seek medical help by attributing one’s mental distress and emotional problems to a physical illness. Somatization is a clinical manifestation, not a diagnosis or disorder. Individuals with somatization are evaluated in a heterogeneous group, and its duration and severity vary depending on the individual’s ability to understand and express their emotions. The common characteristics of people with somatization are generally stated as those who cannot establish a secure and supportive bond with their families and who grow up in complex and unhealthy families7. Worry is defined as a cognitive attempt to solve the problem that is seen as a danger in the future8. Worry is a normal feature of cognitive functioning, but anxious anticipation (extreme worry) about the unpredictable future outcome of events and if it persists without real danger or threat, it turns into anxiety disorders. In this context , the basis of anxiety is the constant experience of worry . Generalized anxiety disorder (GAD) is an anxiety disorder in which anxiety becomes widespread and chronic with excessive worrying. ‘Excessive and uncontrollable worry’ is the main feature of GAD. Muscle tension is defined as a disorder accompanied by symptoms such as sleep disorders, difficulty in clearing the mind or concentrating, getting tired easily, feeling tense and restless or on edge. People with GAD generally worry about even the smallest situations that others may not worry about, and they worry not only about one issue but also about many issues (work, family, financial, health, school, relationship problems)10. One of the important reasons for the formation of generalized anxiety is the loss of parents in the early period or defective parental attitudes11. Dugas’ cognitive model of GAD is based on intolerance to uncertainty12. People with GAD have a low tolerance for uncertainty, they can hardly tolerate it13 . When the literature is examined, it is seen that the studies on the importance and effects of the father-child relationship are quite limited compared to the mother-child studies. For this reason, it is aimed to emphasize the importance and effects of the interaction between father and child in the early period and to contribute to the literature. The relationship between somatization tendency, anxiety and anxiety of people who grew up with acceptance/rejecting behaviors perceived from their fathers in the early period was examined together with the PARQ subscales.

The population of the research consists of 228 people, aged between 18 and 65, living in Istanbul, with 141 women and 87 men. Persons younger than 18 and older than 65 were not included in the study. Participants were recruited by simple random sampling. The research is a cross-sectional study and participation is on a voluntary basis. The Participant Information and Voluntary Consent Form prepared by the researcher (psychologist) was used in order to obtain approval from the participants who agreed to participate in the study and to provide information about the purpose of the study. Sociodemographic Information Form, Adult Parental Acceptance/Rejection Scale-Father Form (Y-PARQ), Somatization Scale and Worry and Anxiety Scale (EAS) were used as data collection tools. Sociodemographic Information Form The sociodemographic information and data form used in the study was prepared by the researcher; It includes questions aimed at obtaining information about gender, age, number of siblings, marital status, educational status, economic status and health problems (Table 1). Adult Parental Acceptance/Rejection Scale-Father Form (Y-PARQ) Adult Parental Acceptance/Rejection Scale (Y-PARQ) was developed by Rohner et al. (1978) to measure perceived parental acceptance and rejection levels. It is a four-point Likert type scale. The Father form of the long version of the scale (standard – 60 items) was used in the study. The scale has 4 sub-dimensions: (1) warmth/affection (reverse coldness) (20 items), (2) hostility/aggression (15 items), (3) indifference/neglect (15 items), and undifferentiated rejection (10 items)14 . All items constituting the warmth/affection sub-dimension and 7 items constituting the indifference/neglect sub-dimension of the scale are reverse scored. All items in the warmth/affection subscale of the Y-PARÖ scale were coded as reversed and included in the analysis in this way. Therefore, especially when taking the total score, the sum of all subscales indicates the participant’s negative perceptions of his father’s parenting. While interpreting the warmth/affection (reverse coldness) subscale, since each item was coded in reverse, this subscale represents the coldness perceived by the participants from their father. The sum of the scores obtained as a result of the answers given to the 4 sub-dimensions gives the total PARQ score, and this score ranges from 60 (lowest) to 240 (highest). The total score obtained as a result of the scale shows the level of acceptance-rejection that people perceive about their mother or father. High scores obtained from the scale indicate the rejection of the people’s perceived attitudes towards their parents and low warmth. However, a high score indicates a high level of rejection. The adult PARQ long form has been translated into forty-eight languages, and as a result of studies, it has been found to have sufficient reliability and validity15. The Turkish standardization of the long form of the scale was made by Varan (2003) in both normal and clinical samples, and it was found that the internal consistency coefficients of the Mother and Father Forms ranged from 0.86 to 0.9616. The Cronbach’s alpha value of the scale for this study was found to be 0.98. Somatization Scale (SS) Minnesota Multidimensional Personality Inventory (MMPI) is a scale consisting of 33 items in total with somatization subscale items. Each item in the scale is answered with a true or false option. The total score that can be obtained from the scale ranges from 0 (lowest) to 33 (highest), and a high score indicates a high level of somatization7. The Turkish validity and reliability study of the somatization scale was carried out by Dülgerler (2000). In the study, the internal consistency coefficient of the scale was 0.83, the test-retest reliability coefficient was 0.99, and the test-half reliability coefficient was 0.637. The internal consistency coefficient of the scale in this study was found to be 0.96.

Anxiety and Anxiety Inventory (EAS) A self-assessment type scale (EAS) was developed by Dugas et al. (2001). The scale measures the diagnostic criteria of generalized anxiety disorder as defined in DSM-IV (APA, 1994). In this context, the scale measures anxiety issues, excessive and uncontrollable aspects of anxiety, the duration and frequency of the disorder, somatic symptoms, anxiety and helplessness due to anxiety, and its intervention in one’s life. The lowest score that can be obtained from the Anxiety and Anxiety Scale, which is a nine (0-8) point Likert type scale, is 0, while the highest score is 80. In order to calculate the total score of the scale, the responses given to all items are obtained by summing the responses given to 11 items, excluding the responses in item 110. The validity and reliability study of the Anxiety and Anxiety Scale into Turkish was conducted by Akyay (2016). In the study, the internal consistency coefficient of the scale was found to be 0.90, and the test-retest reliability coefficient was found to be 0.5210. The internal consistency coefficient of the scale in this study was found to be 0.95. FINDINGS For the analysis of the information obtained; SPSS (Statistical Package Program for Social Science) version 21.0 program was used. Frequency Analysis was used to determine the distribution of the variables in the Sociodemographic Data Form. In order to determine the difference between the applied scales and the variables in the Sociodemographic Data Form, t-Test Analysis in Independent Groups and One-Way Analysis of Variance were used. Pearson Correlation Analysis was used to determine the relationship between the scales and Regression Analysis was used to predict the relationship between the scales. Sociodemographic Findings in the Study Descriptive statistical findings of the sample are shown in Table 1. According to the results of the analysis; there was no statistically significant difference between father acceptance/rejection, somatization, anxiety and anxiety and gender (p>0.05). There was no statistically significant difference between the person experiencing father acceptance/rejection, somatization, anxiety and anxiety (p>0.05). Y-PARQ, SS and SPS scores differ significantly according to the complaint of the disease (p≤0.05). Y-PARQ (T(222)=7.553; p=0.000), SS (T(222)= 7.746; p=0.000) and STS (T(222)=5.657; p=0.000) scores of participants with a complained disorder It was found to be significantly different and higher than the participants who did not have a complaint. Y-PARQ, SS, and SPS scores differ significantly according to the status of going to the doctor for the complaint complained of (p≤0.05). Y-PARQ (T(134)= 5.281; p=0.000), SS (T(134) =6,172; p=0.000) and AES (T(134)=4.993; p=0.000) of the participants who went to the doctor for a complaint they complained about. ) scores were found to be significantly different and higher than the participants who did not go to the doctor for the complained disorder. There was no statistically significant difference between father acceptance/rejection, somatization, worry and anxiety and diagnosed health problem (p>0.05). There was a significant difference between the Y-PARQ (F(4,223)=12.860; p=0,000), SS (F(4,223)=7,539; p=0,000) and STS (F(4,223)=4,255; p=0,000) scores and the number of siblings. there is a difference. It was determined that the Y-PARQ and SS scores of the participants with five or more siblings were higher than the participants with the other number of siblings. It was determined that the participants with four siblings had higher STS scores than the participants with the other number of siblings.

Y-PARQ (F(2,223)=138,158; p=0,000), SS (F(2,223)=112,545; p=0,000) and SSAS (F(2,223)=79,748; p=0,000) scores and economic level there is a difference. It was determined that the participants with low economic status had higher Y-PARQ, SS, and IAS scores than participants with medium and high economic status. Y-PARQ (F(3,224)=11.871; p=0.000), SS (F(3,224)=9.588; p=0.000) and EAS (F(3.224)=5.492; p=0.001) scores and the marital status of the parents there is a significant difference. It was determined that the participants whose parents were divorced had higher Y-PARQ, SS, and EAS scores than the other participants. There was a significant difference between the Y-PARQ (F(4,223)=18,657; p=0,000), SS (F(4,223)=17,959; p=0,000) and EAS (F(4,223)=8,444; p=0,000) scores and father’s education level. There is a level difference. It was determined that the Y-PARS, SS, and EAS scores of the participants whose fathers were secondary school graduates were higher than those whose fathers were illiterate, primary school and university graduates. Y-PARQ, SS scores differ significantly according to age (p≤0.05). The Y-PARQ (p=0.000) and SS (p=0.000) scores of the participants over 35 years old were found to be significantly different and higher than the participants aged 35 and younger.

Regression analysis to determine the relationship between somatization and father acceptance/rejection yielded a significant result (F=536.372; p=0.000). The model explains about 70% of the total variance of somatization. When the t-test results regarding the significance of the regression coefficients are examined, it is seen that father acceptance/rejection is a significant predictor of somatization. The increase in the somatization levels of the individuals participating in the study increases the parental acceptance/rejection levels (β=0.164, p=0.000) (Table 3). It is seen that two variables are important predictors in terms of their contribution to the variance regarding SS scores. In the first stage, the Neglect/ Indifference variable, which explained the most variance with 69.4%, was included in the analysis (β = 0.637, t = 22.686, p ≤ 0.05). There is a positive relationship between Neglect/Indifference and SS. As the level of neglect/indifference increases, there is an increase in the level of SS. In the second stage of the analysis, Hostility/Aggression was included in the model. Hostility/Aggression (β = 0.232, t = 3.930, p ≤ 0.05) explained 1.8% of the variance and thus these two variables explained 71.2% of the variance. There is a positive relationship between hostility/aggression and SS. As the level of hostility/aggression increases, there is an increase in the level of SS (Table 3). Regression analysis to determine the relationship between worry and anxiety and father acceptance/rejection yielded a significant result (F=261,874; p=0.000). The model explains approximately 53.7% of the total variance of anxiety and anxiety. When the t-test results regarding the significance of the regression coefficients are examined, it is seen that parental acceptance/rejection is a significant predictor of anxiety and anxiety. The increase in the anxiety and anxiety levels of the individuals participating in the research increases the levels of parental acceptance/rejection.

It is seen that two variables are important predictors in terms of their contribution to the variance regarding STS scores. In the first stage, the Neglect/Indifference variable, which explains the highest variance with 51.3%, was included in the analysis (β = 1.098, t = 15.487, p ≤ 0.05). There is a positive relationship between Neglect/Indifference and IAI. As the level of Neglect/Indifference increases, there is an increase in the level of IAI. In the second stage of the analysis, Hostility/Aggression was included in the model. Hostility/Aggression (β = 0.571, t = 3.828, p ≤ 0.05) explained 2.7% of the variance and thus these two variables explained 54% of the variance. There is a positive relationship between Hostility/Aggression and IAI. As the level of hostility/aggression increases, there is an increase in the level of IAI (Table 4). DISCUSSION Participants with divorced parents perceive more rejection from their fathers. After the divorce, she may feel neglected and rejected by her father, since the care of the children is usually the responsibility of the mother. Kaya and Gündüz (2019), in a study with children, concluded that divorced parents perceive more rejection in their children than the father in general17. Öngider’s (2013) study with a sample of children found that families with divorced parents had statistically significant higher scores on the subscales of paternal neglect and undifferentiated rejection compared to married ones. According to the researcher, the reason for this result is shown as the father’s departure from home after the divorce18. The result of the study is similar to the literature. It has been shown that participants whose parents are divorced have higher somatization scores. According to the findings of a small number of studies in the literature, somatization does not differ according to the marital status of the parents17,19. The person who grows up in the family model with divorced parents may feel rejected and lonely, he can use his bodily complaints to get rid of his anxiety and fears, in this way he can receive the love and attention of his father (secondary gain). In the study, generalized anxiety levels of those whose parents were divorced were found to be significantly higher. In Turan Cebeci’s (2009) study, it was determined that the state and trait anxiety scores of people who grew up in families with divorced parents were significantly higher than the state and trait anxiety scores of people whose parents were not divorced20. It can be said that the stress and emotional reasons experienced by people whose parents are divorced make people more prone to generalized anxiety. There is a strong relationship between family problems, anxiety and being a child of a divorced family21. Participants with low economic income perceive more paternal rejection compared to medium and high levels. When the result is compared with the literature22, 23. In Deniz’s (2014) study, people with low and middle incomes perceived more parental rejection than those with high income22. Abacı’s (2018); According to the study, the total father rejection score was found to be higher in low and middle income compared to high income23. In a study conducted in China, Chen and Rubin (1994) found a negative relationship between family economic income and parental acceptance. To explain this situation, it was stated that while trying to earn more, parents neglect their children and care less. It has been reported that families with low economic status have higher expectations for their children to be successful and may spend more time with their children24. It was found that the somatization scores of the participants with low economic level were higher than the participants with medium and high economic income. When the studies are examined, it is seen that although the sample is child/adolescent, the result found is similar to the literature25, 26 . According to Özer (2011), adolescents with low economic income show more somatization, anxiety, negative self and depression symptoms25. In Kadıoğlu’s (2018) study on Ekar, it was observed that somatic symptoms in children increased as the economic level of the parents decreased26. When economic income was evaluated for Anxiety and Anxiety, it was determined that the general anxiety scores of the participants with low economic income were significantly higher. In field studies, it has been reported that GAD is more common in people with low income27, 28. This can be interpreted as people with low economic income may look at life more hopelessly and feel anxious and anxious. In addition, some researchers have stated that demographic variables other than gender are not a definite predictor for GAD29. When the relationship between PARQ and the number of siblings was examined, people with five or more siblings perceived more rejection from their fathers. As the number of siblings increases, the time parents can devote to a child decreases. The division of interest in other siblings may cause the perception of rejection. Abacı’s (2018) study found a positive correlation between the increase in the number of siblings and parental rejection23. In another study, it was concluded that the number of siblings affected the attitudes of the family30. There are studies supporting the study in the literature23, 31. In the study conducted by Karaboğa and Eker (2018) with high school students, it was concluded that the sub-dimensions of perceived hostility/aggression and neglect/indifference from the father were statistically significant and high in those with four and five siblings31. When the relationship between somatization and number of siblings is examined, it is concluded that people with five or more siblings have high somatization scores. When the literature is examined, it is observed that the studies do not show consistency with each other. Teken et al. (2019) stated in their study with children and adolescents that the number of siblings does not have a significant effect on somatization and anxiety19. Yıldırım et al. (2008), in a study examining the mental health of nursing students, concluded that people with 4 or more siblings were effective in revealing less mental symptoms, and they related this result with the social support provided by siblings32. When the relationship between STS and the number of siblings was examined, it was found that the generalized anxiety scores of the participants with four siblings were higher than the other participants. Demiriz and Ulutaş (2003) found that as the number of siblings increases, the level of trait anxiety increases33. In another study supporting this, it was stated that the trait anxiety levels of people who grew up in a nuclear family were lower than those who grew up in an extended family34. The number of siblings may affect anxiety depending on the economic status of the family and the attitudes and behaviors of the parents. Parents do not exhibit equal attitudes among siblings, conflict between siblings, and the inability to meet the needs of children in families with a high number of siblings with insufficient economic level can cause anxiety. Unlike the study, it is seen in studies that generalized anxiety does not differ according to the number of siblings35, 36 . Participants whose fathers are secondary school graduates perceive more rejection than others. When the literature is examined, there is no study that deals with PARQ and father’s education in detail. It is stated that parental rejection is more common in less educated parents37. No study has been found in the literature examining the relationship between father acceptance/rejection and father’s educational status. It was determined that the somatization scores of the participants whose fathers were secondary school graduates were higher than other fathers’ education levels. In some studies, it has been concluded that people with low educational level show less emotional awareness38. In the study of Dığrak et al. (2014), it was seen that people with low education level had higher somatization scores39. It is known that the increase in the level of education contributes to the development of the ability to express oneself and emotions correctly. It was determined that the generalized anxiety scores of the participants whose fathers were secondary school graduates were higher than other fathers’ education levels. It has been observed that the studies in the literature are limited on this subject. Demiriz and Ulutaş (2003); In their studies, it was seen that the trait anxiety levels of the children of fathers who graduated from high school and higher education were lower than the other groups. It is thought that this situation will enable the child to raise children who are compatible with the environment and have low anxiety levels, together with the increase in the education of the father, and the increase in the education of the father positively affects the anxiety levels33. According to the studies, the attitudes of parents with a high education level and parents who are primary school graduates to their children may differ. In a similar study, it was determined that the anxiety levels of people whose parents were high school graduates were low40. Discussing the Results of the Relationship between Father Acceptance/Rejection and its Sub-Dimensions and Somatization and Anxiety It is seen that somatization increases as the perceived coldness, neglect, hostility, and undifferentiated rejection from the father increase. When the somatization effect of PARQ and its sub-dimensions is examined, it is seen that paternal neglect/indifference and hostility/aggression sub-dimensions significantly predict somatization. Early maladaptive schemas may occur due to dysfunctional interaction with one of the attachment figures in childhood and unmet basic emotional needs. These schemas can come from early childhood to adulthood and affect an individual’s whole life41. A significant relationship was found between somatization and parental inability to show the necessary attention or provide adequate care to the child in early childhood42. According to Young et al. (2003), early maladaptive schemas can cause many psychological disorders such as depression, anxiety, substance abuse, and it has been one of the most common in somatization41. In parallel with the study, Lackner, Gudleski, and Blanchard’s (2004) study concluded that there is a strong relationship between perceived hostility and aggression (rejection) from the father and somatization symptoms43. In the study of Kaya and Gündüz (2019), it was concluded that somatic symptoms were mostly related to the perceived hostility from the father subscale, and it was observed that as the perceived hostility from the father increased, somatic symptoms increased17. Kaplan and Ak (2018), in a study examining psychological symptoms and problematic behaviors in adolescents, found that the somatization score average of adolescents who stated their (authoritarian, protective, apathetic, perfectionist, democratic) father and mother attitudes as authoritarian and disinterested was higher than the other attitudes44. According to Leff (1973), in many societies it is not considered appropriate to show emotions comfortably, so emotions are usually expressed through somatic symptoms45. Somatic symptoms can be seen in societies, especially with the tendency to suppress feelings and thoughts against the source of authority. Societies have assigned various duties to the role of mother and father. Especially in some cultures, caring for the baby and physical-emotional interaction with the child have been associated only with the role of mother46. According to a research report by Açev (2017), when the views of fathers participating in the study on the role of paternity were evaluated, some participants defined their roles as merely meeting the child’s material needs47. Accordingly, it is possible to mention that patriarchal values ​​maintain their influence and that it is a problem resistant to change. In societies with this belief and structure, fathers have less physical-verbal interaction with their children than mothers. Childhood traumatic experiences and nonverbal emotions (preventing the verbal expression of emotions) can lead to the development of somatothymic language, which is an action based on learning48. Lamb (2000) argues that fathers have an important role in the healthy development of children, although the intercultural father-child relationship differs between different cultures49. The fact that the study was conducted with people between the ages of 18-65 and the detailed investigation of the father PARQ sub-dimensions makes the study different. The obtained results are considered to be an important contribution to the literature. When the relationship between PARQ sub-dimensions and anxiety is examined; It was determined that the anxiety and anxiety scores of the participants who perceived coldness, neglect, hostility and undifferentiated rejection from their fathers increased. It is seen that neglect/indifference and hostility/aggression, which are subscales of PARQ, significantly predict generalized anxiety. In the first question, which was not included in the statistics in the scale, the participants were asked about the issues that frequently worried them. When the anxiety subjects in the sample were examined, it was observed that the subjects such as health, future, work, children, exams, family pressure were frequently included. Anxiety appears to be pervasive in many areas of their lives. Azevedo et al. (2013) emphasized in their study that the most important factor increasing the trait anxiety level of adolescents is perceived father rejection50. According to Rohner (1986), how a person will psychologically construct his general ideas about life and the world will be shaped by the experiences of acceptance or rejection, especially in his relationship with his parents. Accordingly, the baby begins to perceive himself as a whole with his mother in the womb, and there is a father figure in his first communication with the outside world. With the recognition of the outside world and the father, a person’s perspective on life begins to form. People who perceive rejection see life as threatening, unsafe place, bad, dangerous and full of uncertainties because of their negative worldview51. It is possible for them to be highly sensitive to any threat, to experience intense anxiety about daily problems, and to show symptoms of anxiety disorder as a result. When we look at the literature, there are studies on the perceived father rejection as the most important factor increasing the level of trait anxiety50,52,53. In addition, there are studies showing the relationship between perceived rejection-based parental neglect behaviors in early childhood and anxiety54,55. However, the fact that the study was conducted only on fathers gave clarity to the research. No similar study was found in the literature with ITS. Therefore, the findings are considered as a contribution to the literature. The main results reached in this study are as follows:  A positive correlation was found between PARQ subscales, coldness, neglect/indifference, undifferentiated rejection, hostility/aggression, and somatization and anxiety. Neglect/indifference and hostility/aggression subscales were found to predict somatization and anxiety.  Father Accept/Reject; number of siblings, economic level, parental marital status, father’s education level and age vary significantly.  Somatization; number of siblings, economic level, parental marital status, father’s education level and age vary significantly.  Anxiety and Anxiety; The number of siblings differs significantly according to the variables of economic level, parental marital status, and father’s education level. When the results of our study were examined, it was observed that father acceptance/rejection was significantly and significantly associated with somatization and anxiety. It is seen that fathers’ showing love (accepting) behaviors are influenced by society and culture. However, although society and culture are not fixed, they are structures that are open to change. It is foreseen that situations that are seen as social problems can be prevented, especially by raising awareness of the society on this issue. Preventive trainings can be organized to explain the impact of the perception of acceptance and rejection with the father in the early childhood period. These training programs are cognitive-behavioral-based for adults and can focus on how fathers can have a more qualified and healthy relationship with their children. In addition, due to the connections between emotions and physical symptoms, mind-body processes can be focused and studies that raise awareness in this direction can be carried out. Limitations The study was conducted with data obtained from 228 volunteer participants in the province of Istanbul. Consent was requested with an informed consent form and voluntary participants who gave consent were included in the study. It was thought that the people participating in the study might try to show their relationships well in questions about themselves and their fathers and give misleading answers, which may affect the results of the research. The fact that the father’s education level of the majority of the sample is primary and secondary school, and the economic level is higher than the middle and low level, is also a factor that increases the limitation of the study. It is thought that it is important to consider these limitations in future studies. Despite the limitations, it is thought that the study will contribute to future studies as it sheds light on the importance of perceived acceptance-rejection from the father and has shown its relationship with somatization and generalized anxiety. Statement of Compliance with the Ethical Principles Permission was obtained for the study, numbered 61351342/2019-532, on 27.11.2019 from the Üsküdar University Non-Interventional Research Ethics Committee. Conflict of interest All authors of this article declare that there is no conflict of interest regarding the article.

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