School of Psychology, University of Sydney, NSW, Australia.
School of Psychology, University of Sydney, NSW, Australia.
J Affect Disord. 2018 Jan 15;226:12-20. doi: 10.1016/j.jad.2017.09.010. Epub 2017 Sep 14.
The aim of this study was to examine the relationship between family environment (cohesion and parental bonding), high-risk status, and psychopathology (internalizing and externalizing problems) among offspring of parents with bipolar disorder (BD), from the perspective of both offspring and their parents. We further tested if family environment mediated the relationship between bipolar risk status and internalizing and externalizing problems.
High-risk (n = 90) BD offspring and control (n = 56) offspring aged 12-21 years old, and their parents, completed questionnaires on family cohesion and offspring internalizing and externalizing problems. Offspring also completed a parental bonding questionnaire. Group differences were examined, followed by multi-level mediation analysis with maximum likelihood and robust standard errors.
Both offspring and parents in the high-risk group reported higher levels of internalizing and externalizing problems than controls. According to offspring reports, high-risk status, lower maternal and paternal care in parental bonding, was independently associated with internalizing problems. Lower maternal care alone predicted externalizing problems. Family environment did not mediate the relationship between bipolar risk status, and offspring problems.
Due to rates of missing data from parent reports of offspring psychopathology, mediation analysis was completed using offspring reports.
The offspring-report data presented indicate that low parental warmth and connection were associated with internalizing and externalizing problems as an independent risk factor, in addition to bipolar risk status. The parent-child relationship therefore warrants attention as a potential target for prevention strategies with such families.
本研究旨在从子女及其父母的角度，探讨双相障碍（BD）父母的子女的家庭环境（凝聚力和父母养育）、高危状况与精神病理学（内化和外化问题）之间的关系。我们进一步检验了家庭环境是否在双相风险状况与内化和外化问题之间起中介作用。
12-21 岁的高风险（n=90）BD 子女和对照组（n=56）子女及其父母完成了家庭凝聚力和子女内化和外化问题的问卷。子女还完成了一份父母养育问卷。我们首先检验了组间差异，然后使用最大似然法和稳健标准误差进行了多层次中介分析。
高风险组的子女和父母都报告了比对照组更高水平的内化和外化问题。根据子女的报告，高风险状况、父母养育中的较低的母子和父子关爱与内化问题独立相关。较低的母子关爱单独预测了外化问题。家庭环境并不能中介双相风险状况与子女问题之间的关系。
由于父母报告子女精神病理学的缺失率较高，因此中介分析仅使用了子女的报告。
所呈现的子女报告数据表明，除了双相风险状况外，父母的温暖和联系较少与内化和外化问题是独立的风险因素。因此，亲子关系需要作为此类家庭的潜在预防策略目标受到关注。
