Adaptation to bipolar disorder and perceived risk to children: a survey of parents with bipolar disorder

BMC Psychiatry

Barbara B Biesecker¹  Donald L Rosenstein²  Holly L Peay¹ 

[1]Social and Behavioral Research Branch, National Human Genome Research Institute NHGRI, Building 31 Room B1B36 31 Center Drive MSC 2073, Bethesda, MD 20892, USA

[2]Department of Psychiatry and Comprehensive Cancer Support Program, University of North Carolina at Chapel Hill, Physicians Office Building, Room 3134, Chapel Hill, NC 27599, USA

关键词: Risk perception;    Genetic;    Quality of life;    Adaptation;    Bipolar disorder;   

Others  :  1123869
DOI  :  10.1186/1471-244X-13-327

 received in 2012-11-16, accepted in 2013-11-12,  发布年份 2013

【 摘 要 】

Background

Bipolar disorder (BPD) is a common condition associated with significant morbidity and reduced quality of life. In addition to challenges caused by their mood symptoms, parents affected with BPD harbor concerns about the mental health of their children. Among adult parents who perceive themselves to have BPD, this study aims to examine participants’ coping methods; identify predictors of adaptation; assess parental perceptions of risks for mood disorders among their children; and describe the relationships among illness appraisals, coping, adaptation to one’s own illness, and perceived risk to one’s children.

Methods

Parents who self-identified as having BPD completed a web-based survey that assessed dispositional optimism, coping, perceived illness severity, perceived etiology of BPD, perceived risk to offspring, and adaptation to BPD. Participants had at least one unaffected child who was 30 years of age or below.

Results

266 parents were included in the analysis. 87% of parents endorsed a “somewhat greater” or “much greater” risk for mood disorders in one’s child(ren) than someone without a family history. Endorsing a genetic/familial etiology to BPD was positively correlated with perceived risk for mood disorders in children (r_s = .3, p < 0.01) and active coping with BDP (r = .2, p < 0.01). Increased active coping (β = 0.4, p < 0.001) and dispositional optimism (β = 0.3, p < 0.001) were positively associated with better adaptation, while using denial coping was negatively associated with adaptation (β = −0.3, p < 0.001). The variables explained 55.2% of the variance in adaptation (F = 73.2, p < 0.001). Coping mediated the effect of perceived illness severity on adaptation.

Conclusions

These data inform studies of interventions that extend beyond symptom management and aim to improve the psychological wellbeing of parents with BPD. Interventions targeted at illness perceptions and those aimed at enhancing coping should be studied for positive effects on adaptation. Parents with BPD may benefit from genetic counseling to promote active coping with their condition, and manage worry about perceived risk to their children.

【 授权许可】

   
2013 Peay et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Bowden CL, Perlis RH, Thase ME, Ketter TA, Ostacher MM, Calabrese JR, Reilly-Harrington NA, Gonzalez JM, Singh V, Nierenberg AA, et al.: Aims and results of the NIMH systematic treatment enhancement program for bipolar disorder (STEP-BD). CNS Neurosci Ther 2011, 18(3):243-249.
• [2]Michalak EE, Murray G, Young AH, Lam RW: Burden of bipolar depression: impact of disorder and medications on quality of life. CNS Drugs 2008, 22(5):389-406.
• [3]Suto M, Murray G, Hale S, Amari E, Michalak EE: What works for people with bipolar disorder? Tips from the experts. J Affect Disord 2010, 124(1–2):76-84.
• [4]Peay HL, Hooker GW, Kassem L, Biesecker BB: Family risk and related education and counseling needs: perceptions of adults with bipolar disorder and siblings of adults with bipolar disorder. Am J Med Genet A 2009, 149A(3):364-371.
• [5]Du Rocher Schuldich TD, Youngstrom EA, Calabrese JR, Findling RL: The role of family functioning in bipolar disorder in families. J Abnorm Child Psychol 2008, 36(6):849-863.
• [6]Hodgins S, Faucher B, Zarac A, Ellenbogen M: Children of parents with bipolar disorder: a population at high risk for major affective disorders. Child Adolesc Psychiatr Clin N Am 2002, 11(3):533-553.
• [7]Guan B, Deng Y, Cohen P, Chen H: Relative impact of Axis I mental disorders on quality of life among adults in the community. J Affect Disord 2011, 131(1–3):293-298.
• [8]Watson HJ, Swan A, Nathan PR: Psychiatric diagnosis and quality of life: the additional burden of psychiatric comorbidity. Compr Psychiatry 2011, 52(3):265-272.
• [9]Biesecker BB, Erby L, Woolford S, Adcock JY, Cohen J, Lamb A, Lewis K, Truitt M, Turriff A, Reeve BB: Development and validation of the psychological adaptation scale (PAS): use in six studies of adaptation to a health condition or risk. Patient Educ Couns 2013, 93(2):248-254.
• [10]Carver CS, Connor-Smith J: Personality and coping. Annu Rev Psychol 2010, 61:679-704.
• [11]Pavlickova H, Varese F, Smith A, Myin-Germeys I, Turnbull OH, Emsley R, Bentall RP: The dynamics of mood and coping in bipolar disorder: longitudinal investigations of the inter-relationship between affect, self-esteem and response styles. PLoS One 2013, 8(4):e62514.
• [12]Lam D, Wong G, Sham P: Prodromes, coping strategies, and course of illness in bipolar affective disorder–a naturalistic study. Psychol Med 2001, 31(8):1397-1402.
• [13]Lazarus RS, Folkman S: Stress, appraisal, and coping. New York: Springer Publishing Company; 1984.
• [14]Trippitelli C, Jamison K, Folstein M, Bartko J, DePaulo J: Pilot study on patients’ and spouses’ attitudes toward potential genetic testing for bipolar disorder. Am J Psychiatry 1998, 155(7):899-904.
• [15]Quaid KA, Aschen SR, Smiley CL, I NJ: Perceived genetic risks for bipolar disorder in a patient population: an exploratory study. J Genet Counsel 2001, 10:41-51.
• [16]Austin J, Smith G, Honer W: The genomic era and perceptions of psychotic disorders: genetic risk estimation, associations with reproductive decisions and views about predictive testing. Am J Med Genet B Neuropsychiatr Genet 2006, 141(8):926-928.
• [17]Bienvenu OJ, Davydow DS, Kendler KS: Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence. Psychol Med 2011, 41(1):33-40.
• [18]Goodwin F, Jamison K: Manic depressive illness. London: Oxford Press; 1990.
• [19]Nurnberger JL, Berrettini W: Psychiatric genetics. London: Chapman and Hall; 1998.
• [20]Targum S, Dibble E, Davenport Y, Gershon E: The family attitudes questionnaire: patients’ and spouses’ views of bipolar illness. Arch Gen Psychiatry 1981, 38(5):562-568.
• [21]Meiser B, Mitchell P, Kasparian N, Strong K, Simpson J, Mireskandari S, Tabassum L, Schofield P: Attitudes towards childbearing, causal attributions for bipolar disorder and psychological distress: a study of families with multiple cases of bipolar disorder. Psychol Med 2007, 37(11):1601-1611.
• [22]Broadbent E, Petrie KJ, Main J, Weinman J: The brief illness perception questionnaire. J Psychosom Res 2006, 60(6):631-637.
• [23]Broadbent E, Kydd R, Sanders D, Vanderpyl J: Unmet needs and treatment seeking in high users of mental health services: role of illness perceptions. Aust N Z J Psychiatry 2008, 42(2):147-153.
• [24]Baines T, Wittkowski A: A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model. J Clin Psychol Med Settings 2012, 20(3):263-274.
• [25]Scheier MF, Carver CS: Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol 1985, 4(3):219-247.
• [26]Thomas JL, Britt TW, Odle-Dusseau H, Bliese PD: Dispositional optimism buffers combat veterans from the negative effects of warzone stress on mental health symptoms and work impairment. J Clin Psychol 2011, 67(9):866-880.
• [27]Carver CS: You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med 1997, 4(1):92-100.
• [28]Meyer B: Coping with severe mental illness: relations of the brief COPE with symptoms, functioning, and well-being. J Psychopathol Behav 2001, 23(4):265-277.
• [29]Vos J, Gomez-Garcia E, Oosterwijk JC, Menko FH, Stoel RD, van Asperen CJ, Jansen AM, Stiggelbout AM, Tibben A: Opening the psychological black box in genetic counseling: the psychological impact of DNA testing is predicted by the counselees’ perception, the medical impact by the pathogenic or uninformative BRCA1/2-result. Psychooncology 2010, 21(1):29-42.
• [30]Wilhelm K, Wedgwood L, Parker G, Geerligs L, Hadzi-Pavlovic D: Predicting mental health and well-being in adulthood. J Nerv Ment Dis 2010, 198(2):85-90.
• [31]Tomakowsky J, Lumley MA, Markowitz N, Frank C: Optimistic explanatory style and dispositional optimism in HIV-infected men. J Psychosom Res 2001, 51(4):577-587.
• [32]Glaesmer H, Rief W, Martin A, Mewes R, Brähler E, Zenger M, Hinz A: Psychometric properties and population-based norms of the life orientation test revised (LOT-R). Br J Health Psychol 2011, 17(2):432-445.
• [33]Chesney MA, Chambers DB, Taylor JM, Johnson LM, Folkman S: Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group-based intervention. Psychosom Med 2003, 65(6):1038-1046.
• [34]Hippman C, Lohn Z, Ringrose A, Inglis A, Cheek J, Austin JC: “Nothing is absolute in life”: understanding uncertainty in the contex of psychiatric genetic counseling from the perspective of those with serious mental illness. J Genet Couns 2013, 22(5):625-632.