Family functioning in the context of parental bipolar disorder: Associations with offspring age, sex, and psychopathology.

Abstract

Previous research has shown that families with a parent who has bipolar disorder (BD) may experience family functioning difficulties. However, the association between family functioning and psychopathology among offspring of parents with BD, and offspring characteristics that may moderate this association, remains poorly understood. This study examined the cross-sectional associations between family functioning (cohesion, expressiveness, and conflict) and psychopathology in 117 offspring (ages 5-18) of 75 parents with BD. We also examined whether age and sex differences moderated these associations. We measured offspring psychopathology by examining current dimensional symptoms and DSM-IV emotional and behavioral disorders. Correlational analyses indicated that higher family conflict and lower cohesion were associated with higher internalizing and externalizing symptoms in offspring. Lower family cohesion was also associated with current offspring mood disorders. Moderation analyses indicated, first, that the link between lower family cohesion and internalizing symptoms was stronger for younger offspring compared to older offspring. Second, higher family conflict and current mood disorder were associated in younger males but not in older males or in females. Results remained the same after controlling for parental anxiety or substance use disorder comorbidity. Our study highlights the importance of accounting for family functioning when working with offspring at risk for BD, while also recognizing that the connections between family functioning and offspring outcomes are complex and differ based on offspring sex and developmental stage.

Neurobiology of bipolar disorders: a review of genetic components, signaling pathways, biochemical changes, and neuroimaging findings

“…[44][45][46][47][48] This familial aggregation suggests a potential relevance of both inherited genes, which can be tested by molecular genetic analyses, and the ''inherited'' familial environment, which is also known to be potentially impaired in the face of parental psychopathology. 49,50 In the search for relevant BD-related genes, several genome-wide association studies (GWASs) conducted in the past years have identified multiple loci with a small effect that may account for heritability, [51][52][53][54][55][56][57][58][59][60][61][62] including 30 recently discovered loci encoding ion channels, neurotransmitter transporters, and synaptic components. 63 None of these single nucleotide polymorphisms (SNPs), Figure 1 Etiology of bipolar disorders.…”

“… 44 - 48 This familial aggregation suggests a potential relevance of both inherited genes, which can be tested by molecular genetic analyses, and the “inherited” familial environment, which is also known to be potentially impaired in the face of parental psychopathology. 49 , 50 …”

Clinical Considerations When Treating Adults Who Are Parents

“…Adult psychopathology often co‐occurs with other conditions that also constitute risk factors for children's development, such as unemployment, poverty, marital problems, and family instability (Freed et al., ; Gassman‐Pines, Ananat, & Gibson‐Davis, ). Moreover, when both parents have psychopathology, which is common, the risk of poor child outcomes increases (Kahn, Brandt, & Whitaker, ; Wesseldijk et al., ).…”

“…The third mechanism of risk transmission is through exposure to other types of stressors, such as increased family conflict, which is associated with development of psychopathology in children (Freed et al., ; Goodman & Gotlib, ). The fourth and final mechanism, and the one that is best understood, is parenting quality.…”

Differences in relationships of maternal and paternal age at childbirth with body fat distribution in offspring

“…In model 3, we additionally adjusted for the other parent's age at childbirth. Because maternal and paternal ages were strongly correlated (Pearson correlation = 0.67), the variance inflation factor (VIF) was used to check the models for co‐linearity (Freed et al, ; Kutner, Nachtsheim, & Neter, ). In all models, the VIFs were approximately 1.9 and 1.8 for paternal and maternal age, respectively.…”