Parental expressed emotion and suicidal ideation in adolescents with bipolar disorder

Abstract

Family environmental variables are risk factors for recurrent courses of mood disorder in adolescents. The present study examined the association between parental expressed emotion (EE)—critical, hostile and/or emotionally overinvolved attitudes toward a concurrently ill offspring - and suicidal ideation in adolescents with bipolar disorder. The sample consisted of 95 adolescents with a bipolar I or II diagnosis who had experienced a mood episode in the prior 3 months. Participants (mean age = 15.54 yrs., SD = 1.4) were interviewed and completed questionnaires regarding current and past suicidal ideation prior to their participation in a treatment trial. Parents completed five-minute speech samples from which levels of EE were assessed. High EE attitudes in parents were associated with current suicidal ideation in adolescents. This relationship was independent of the effects of age, gender, current depressive or manic symptoms, comorbid diagnoses, bipolar I/II subtype, family adaptability, and family cohesion. These results underscore the importance of addressing the emotional reactivity of caregivers in treating adolescents with bipolar disorder who have suicidal ideation.

Loneliness, adolescence, and global mental health:Soledadand structural violence in Mexico

“…Implicated in the subjective experience of soledad is a ''moral valuing'' (Parish, 2014) An anthropological examination of expressed emotion (EE) in familial and friend relationships reveals culturally constituted ideations of interpersonal relationships and their connection to mental health and illness (Jenkins, 2015;Karno, et al, 1987;Brown, Monck, Carstairs, & Wing, 1962). Cross-cultural studies of EE, which include criticism, hostility, emotional overinvolvement, warmth and positive comments within the emotional milieu of the family, have demonstrated the ways in which such emotional atmospheres influence wellbeing, as well as attitudes toward persons living with both psychiatric and non-psychiatric conditions (Jenkins, 2015;Jenkins & Karno, 1992;Blondin, Meilleur, Taddeo, & Frappier, 2019;Ellis, et al, 2014). This literature has illuminated the significance of cultural conceptions surrounding familial relationships and obligations.…”

The Influence of Trauma, Life Events, and Social Relationships on Bipolar Depression

“…Poor family functioning is linked to suicidal ideation in youth with bipolar disorder (53–55). Likewise, low levels of family cohesion and adaptability, and high levels of conflict predicted symptoms of depression (56).…”

Family-Based Interventions for Childhood Mood Disorders

“…12,13 Family relationships and parenting factors including warmth/hostility, attachment, criticism, and parents' coping are possible contributors to children's mood symptoms. 5,[13][14][15][16] High levels of criticism in parent-child relationships are associated with lower child social competence, depressive symptoms, and suicidal ideation. 15,16 Several psychotherapeutic interventions have been developed to address these factors.…”