Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA; Herman Dana Division of Pediatric Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA.
J Am Acad Child Adolesc Psychiatry. 2019 Oct;58(10):961-970. doi: 10.1016/j.jaac.2018.10.011. Epub 2018 Dec 19.
To compare the longitudinal course of family functioning in offspring of parents with bipolar disorder (BD), offspring of parents with non-BD psychopathology, and offspring of healthy control (HC) parents.
Offspring of parents with BD (256 parents and 481 offspring), parents without BD (82 parents and 162 offspring), and HC parents (88 parents and 175 offspring) 7 to 18 years of age at intake, from the Bipolar Offspring Study (BIOS), were followed for an average of 4.3 years. Family functioning was evaluated using the child- and parent-reported Family Adaptability and Cohesion Scale-II and the Conflict Behavior Questionnaire. The data were analyzed using multivariate multilevel regression, generalized linear estimating equation models, and path analysis.
Families of parents with BD and parents with non-BD psychopathology showed lower cohesion and adaptability and higher conflict compared with HC families. There were no significant differences in cohesion and adaptability between families of parents with psychopathology. The effect of parental psychopathology on family functioning was mediated by parental psychosocial functioning and, to a lesser extent, offspring disorders. In all 3 groups, parent-reported family conflict was significantly higher than child-reported conflict. Across groups, family cohesion decreased over follow-up, whereas conflict increased.
Any parental psychopathology predicted family impairment. These results were influenced by the offspring's age and were mediated by parental psychosocial functioning and, to a lesser degree, by offspring psychopathology. These findings emphasize the need to routinely assess family functioning in addition to psychopathology and provide appropriate interventions to parents and offspring.
比较父母患有双相障碍（BD）、父母患有非 BD 精神病理学和健康对照（HC）父母的后代中家庭功能的纵向变化过程。
来自双相后代研究（BIOS）的父母患有 BD（256 名父母和 481 名后代）、父母无 BD（82 名父母和 162 名后代）和 HC 父母（88 名父母和 175 名后代）的 7 至 18 岁的子女，在平均 4.3 年的随访期间，使用儿童和父母报告的家庭适应与凝聚力量表-II 和冲突行为问卷评估家庭功能。使用多变量多层回归、广义线性估计方程模型和路径分析对数据进行分析。
与 HC 家庭相比，父母患有 BD 和非 BD 精神病理学的家庭表现出较低的凝聚力和适应性，以及较高的冲突。患有精神病理学的父母家庭之间在凝聚力和适应性方面没有显著差异。父母精神病理学对家庭功能的影响通过父母的心理社会功能以及在较小程度上通过子女的疾病来介导。在所有 3 组中，父母报告的家庭冲突明显高于儿童报告的冲突。在所有组中，家庭凝聚力随随访时间而降低，而冲突增加。
任何父母的精神病理学都预示着家庭功能受损。这些结果受到后代年龄的影响，并通过父母的心理社会功能以及在较小程度上通过子女的精神病理学来介导。这些发现强调需要除了评估精神病理学之外，还需要定期评估家庭功能，并为父母和子女提供适当的干预措施。
