Do children who grow up in a rigid, repressive home environment end up acting out like Josh Duggar?

The Duggar family scandal makes it easy for us to judge.

After all, parenting 19 children is unthinkable to most. Add strict Bible-believing Christianity and homeschooling to the mix, and a slew of questions arise.

We may never know exactly why the Duggar’s oldest son, Josh, molested his younger sisters or why he subscribed to the infidelity website Ashley Madison or how he became addicted to porn.

This week, the eldest Duggar son checked himself into a rehabilitation center to find answers to these questions, as well as find healing for himself and those he hurt.

Still, we’re left wondering if his behaviors are a direct result of his strict upbringing.

Read More: The Right Mix of Compromise and Punishment »

“It’s not as clear as people think,” said Dr. Joseph Lee, medical director of the Youth Continuum at the Hazelden Betty Ford Foundation. “The reasons people struggle have to do with exposure, environmental stimuli, personal experiences and genetics. Parenting is just one piece of that. For substance use, kids usually use what’s accessible and less taboo. When you get into the other realms like sex, it starts to become more complicated.”

However, Lee told Healthline that science does show that pro-social behaviors, such as learning how to socialize properly, having empathy skills, social reciprocity, and courtesy are predictive of success later in life, perhaps even more so in context than intelligence.

Dr. Hans Steiner, a child, adolescent, and adult psychiatrist and professor emeritus at Stanford University, adds that research shows children raised in authoritarian households end up not understanding collaboration, negotiations, or rules.

“People think this style may mold kids, but the reason it doesn’t is because children are not empty vessels,” Steiner told Healthline. “They have a temperament. There’s somebody in there who wants to do things their way, and to ignore that repeatedly is going to eventually cause massive rebellion.”

When families are large like the Duggars’, Steiner says they usually break down into three or four families with the oldest children taking on parental roles for their younger siblings.

“This is when not-so-good things start to happen because kids are not meant to be parents,” said Steiner.

Parenting coach Carrie Contey, Ph.D., says it really depends on the parents.

“I’ve seen families with one or two kids and it’s not going so great and families of 10 who are rocking it,” Contey told Healthline. “There is a lot of emotional needs for healthy development and brain development early in life so sometimes when a parent is overwhelmed because they have lots of kids under say 5 or 6, it can be very challenging to give all the kids what they need emotionally.”

Lee agrees.

He says while you want to treat kids as evenly as possible in a family, every child is different. The more children you have, the more complex this can get.

“You may have one child who is autistic or one with a learning disability, so you’ll need to parent them differently to some degree,” he said. “I see a lot of families whose kids are dealing with different kinds of addictions, but they have other kids who are doing fine. Sometimes there’s a genetic predisposition. Sometimes the parents did everything right.”

Read More: Positive Parenting in 20 Steps »

When children are raised in a family where there are a lot of rules, judgment, and dogma around ways of living, Contey says even if the parents value this type of living and belief system, it may not be what their children need for healthy development.

“When it isn’t, it can lead children to going off and finding other people to do life with because they don’t feel seen or heard,” she said.

Steiner says when kids are sheltered and aren’t told about other belief systems or religions, this can hinder their development.

“Once kids get to about six years old and up, their families aren’t their only source of information anymore,” he said. “They realize there’s a world out there — teachers who they’ll need to obey, people who have different standards from their family’s, Jews, Muslims, Catholics, Protestants. It’s good for kids to take in all the knowledge and even engage in conversations with their parents about other religions and ways of living.”

Lee does point out that religion, at least when it comes to substance use disorders, has been shown in research to be a moderate protective factor.

“In general, if you can give kids some form of spirituality, this tends to protect them from substance use and sometimes other things,” he explained.

It may be that spirituality is one way to communicate and model a coherent family culture.

“The kids understand the foundational values of the family explicitly. It gives them balance and allows them to understand what they stand by,” Lee added.

If children are told that sex is something that’s bad, evil, or forbidden, Steiner says this can have a big impact on their behavior.

“Having sex can be a scary thing. You can get really sick from it or end up having children,” he said. “So if sex is shamed, a lot of kids will ignore their desires and not do it, which isn’t good for them or for humanity, or they just totally rebel, don’t understand boundaries, or use it like a weapon.”

Contey brings up the phrase: Repression breeds obsession.

“Sometimes people are naturally very sexual so if they’re raised in a household where that’s completely taboo, it can lead to that person struggling and having desires that they may not understand,” she said. “This can make them uncomfortable with who they are, and lead them to acting on their desires in ways that are not good for their development.”

Read More: Sexually Active Teens Get Sex Education Too Late »

It’d be easy for Lee, who largely sees homeschoolers, to make the inference that homeschooling is the reason children struggle.

However, he says if you break down each case, it’s varied.

“Sometimes the kid was having trouble in school, so that’s why the parents pulled him out. Sometimes it was because of religion objection, which may be right or wrong. It’s just not clear cut,” he said.

When patients inform Steiner that they want to homeschool their children, he challenges them to have a superb reason for doing so.

“Some children need extra protection cause they’re intellectually challenged or ill in some way,” he said. “But school is really a giant portal into life and into society and if you take them out of that the chances that they’re going to make it in society will diminish. It doesn’t mean that they won’t make it, but you’re taking away some very important tools.”

With Gallup pollsters reporting that Americans’ ideal number of children per family is 2.6, it’s fair to say that most Americans will never walk in the Duggar family’s shoes.

That doesn’t mean they won’t be faced with a struggling child.

“Even if you do everything perfectly as a parent, there’s a chance that your child will struggle or cross social taboos,” said Lee.

He added that many parents are confused right now.

“Most of the problems I see with parents are those who don’t really have a good cultural foundation,” Lee said. “They want to be their child’s best friend, they want to protect their kid’s autonomy irrespective of their maturity, and they end up overloading their kids with activities and helicoptering, then feel guilty about it. I’d say if there’s a parenting problem in America, it’s probably that.”