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The Role of Family Functioning in Bipolar Disorder in Families

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Abstract

Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children’s risk for bipolar disorder. Participants were 272 families with a child between the ages of 5–17 years. Parents’ history of psychiatric diagnoses and children’s current diagnoses were obtained via semi-structured interviews. Parent report on the Family Assessment Device and the Conflict Behavior Questionnaire measured family functioning and conflict, respectively. Results revealed a small but significant indirect pathway from parental diagnosis of mood disorder to child bipolar disorder through impaired family functioning, via increased family conflict. Parental mood disorders were also significantly related to other negative outcomes in children, including unipolar depression and oppositional defiant disorder. Associations between parent diagnoses and family functioning changed depending on youth age, but not youth sex.

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Notes

  1. Because AMOS does not allow for modeling of latent thresholds for bivariate outcome variables, analyses were also run in M-Plus 4.0, using both WLSMV, ML, and MLR estimators, to explicitly model the thresholds for categorical outcomes. These analyses did not result in any changes in the paths in terms of sign or significance; nor did the models appear to change in terms of fit. We also estimated the polyserial correlations using the “polyserial” procedure in R version 2.4.0 to examine whether modeling them instead of point-biserial estimates would change findings. The polyserial and point-biserial correlations were all well within one standard error of each other. The correlation between youth bipolar spectrum status and CBQ Total score was 0.42 for point-biserial and 0.38 for polyserial estimation (standard error = 0.06). For youth bipolar status and FAD total score, both correlations were 0.01 (with a standard error of 0.08). Given the similarity in findings, the greater range of model comparison statistics available in AMOS versus M-Plus, and the greater congruence between the AMOS model and the current thinking about bipolar disorder as being a spectrum, not a categorical, phenomenon, we chose to present the AMOS results in the main body of the paper. Results of the M-Plus analyses are available upon request from the corresponding author.

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Acknowledgement

This work was supported in part by a Stanley Medical Research Institute clinical research center grant as well as NIMH R01 MH066647.

Disclosures

Robert L. Findling receives or has received research support, acted as a consultant and/or served on a speaker’s bureau for Abbott, AstraZeneca, Bristol-Myers Squibb, Celltech-Medeva, Cypress Biosciences, Forest, GlaxoSmithKline, Johnson & Johnson, Lilly, New River, Novartis, Otsuka, Pfizer, Sanofi-Aventis, Sepracore, Shire, Solvay, Supernus Pharmaceuticals, and Wyeth.

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Authors and Affiliations

  1. Department of Psychology, Western Washington University, 516 High Street, MS 9089, Bellingham, WA, 98225-9089, USA

    Tina D. Du Rocher Schudlich

  2. Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Eric A. Youngstrom

  3. Department of Psychiatry, Case Western Reserve University, Clevelend, OH, USA

    Eric A. Youngstrom, Joseph R. Calabrese & Robert L. Findling

  4. Department of Psychiatry, University Hospitals Case Medical Center, Clevelend, OH, USA

    Joseph R. Calabrese & Robert L. Findling

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  1. Tina D. Du Rocher Schudlich
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  4. Robert L. Findling
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Correspondence to Tina D. Du Rocher Schudlich.

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Table 5 Child age by sex by bipolar diagnosis
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Du Rocher Schudlich, T.D., Youngstrom, E.A., Calabrese, J.R. et al. The Role of Family Functioning in Bipolar Disorder in Families. J Abnorm Child Psychol 36, 849–863 (2008). https://doi.org/10.1007/s10802-008-9217-9

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