Department of Psychology.
J Fam Psychol. 2010 Feb;24(1):60-67. doi: 10.1037/a0018183.
This study examined the characteristics of families of adolescents with bipolar disorder during or shortly following a period of mood exacerbation, using measures of family conflict, cohesion, adaptability, and expressed emotion (EE). Demographic, diagnostic, and family functioning data were collected from 58 families (mean age = 14.48; 33 female, 25 male) before entering a randomized trial of family focused treatment. Compared to scale scores reported by healthy adolescents and their families, cohesion and adaptability were more impaired in families with an adolescent with bipolar disorder. Levels of conflict, while higher than normative scores reported by healthy families, were not significantly different from scores gathered from distressed, clinic-referred families. Parents rated high in EE reported less cohesion and adaptability, and more conflict, than parents rated low in EE. Parents expressing greater numbers of critical comments also reported more conflict than those who expressed fewer criticisms. These EE group differences were not accounted for by concurrent adolescent symptom levels. Family adaptability, cohesion, and conflict may be important targets for family treatments administered during the postepisode phases of early onset bipolar disorder.
本研究使用家庭冲突、凝聚力、适应性和情绪表达（EE）的测量方法，考察了青少年双相情感障碍患者在情绪恶化期间或之后不久的家庭特征。在进入家庭为中心的治疗随机试验之前，从 58 个家庭（平均年龄=14.48；33 名女性，25 名男性）收集了人口统计学、诊断和家庭功能数据。与健康青少年及其家庭报告的量表得分相比，双相情感障碍青少年家庭的凝聚力和适应性受损更为严重。冲突水平虽然高于健康家庭报告的正常分数，但与来自苦恼的、诊所推荐的家庭的分数没有显著差异。EE 评分高的父母报告的凝聚力和适应性较差，冲突较多，而 EE 评分低的父母则报告的冲突较少。表达更多批评意见的父母报告的冲突也多于表达较少批评意见的父母。这些 EE 组间差异不能用同时期青少年症状水平来解释。在早期发病的双相情感障碍的发作后阶段，家庭适应性、凝聚力和冲突可能是家庭治疗的重要目标。
