Family functioning Deficits in bipolar disorder and ADHD in youth

Abstract

Background Rates of diagnosis and treatment for bipolar disorder (BD) in youth continue to rise. Researchers and clinicians experience difficulty differentiating between BD in youth and other conditions that are commonly comorbid or share similar clinical features with BD, especially attention-deficit/hyperactivity disorder (ADHD). Comparative studies of the phenomenology and psychosocial correlates of these conditions help to address this. Family functioning is an important topic for both BD and ADHD since both are associated with numerous family-related deficits. One previous study suggested that manic/hypomanic youths’ family functioning differed from ADHD and typically developing control (TDC) groups. However, many family functioning studies with BD and ADHD youth have methodological limitations or fail to use comprehensive, validated measures. Methods This investigation used adolescent report on the Family Assessment Device (FAD), based on the McMaster Model of family functioning. Youth were recruited in BD (n=30), ADHD (n=36), and TDC (n=41) groups. Results Groups were similar on most demographic variables, but The TDC group scored somewhat higher than the others on IQ and socioeconomic status. FAD results indicated that BD and ADHD groups scored worse than TDC on the General Functioning and Roles scales of the FAD. In addition, the BD group showed impairment on the Problem Solving scale relative to TDC. Limitations sample size, lack of parent report, ADHD comorbidity in BD group. Conclusions Family functioning deficits distinguish both clinical groups from TDC, and problem-solving dysfunction may be specific to BD. These findings may apply to treatment models for both conditions.

Developmental Meta-analyses of the Functional Neural Correlates of Bipolar Disorder

“…Altogether, greater convergence of hyper-activation in the IFG and precuneus among BD-youths versus BD-adults during emotional tasks suggests that these regions play a more significant role in emotion-cognition interactions in BD-youths than in BD-adults. These findings warrant further study, potentially with ecologically-valid psychosocial interaction tasks (e.g., peer rejection 72 ) to explore these alterations’ developmental course in BD and their relationship to patients’ real-world emotional impairment (e.g., family functioning 73 ).…”

The Impact of Rare Genetic Disorders on Family Functioning

“…For instance, families of children with diabetes mellitus type I, which also requires a lot of (family) adjustments in daily life, had a mean score of 1.76 and a standard deviation of 0.39 (6), suggesting that at most ~15% (> +1 standard deviation) of the parents have a pathological level of stress. A study in a small sample of families with a child diagnosed with ADHD scored also around 1.75 35 on the FAD-GF.…”

Therapeutic Engagement of Adolescents with Emotional and Behavioral Disorders

“…However, there was no association between family functioning and total youth engagement, an unexpected finding, since interpersonal functioning is generally thought to be greatly influenced by one's relationships with family members (Bowlby, 1969(Bowlby, , 1982(Bowlby, , 1988Young et al, 2013). One possible explanation is that, residential treatment youth scored in the clinical range on the FAD, while day treatment youth did not.…”