The Relationship of Parental Personality Disorders with Offspring Eating Disorders at Childhood and Adolescence Age

This study aimed to investigate parents' PDs that could be associated with children and adolescents' EDs. We studied association of parental PDs with offspring EDs in age group 6-18 years in a nationally representative sample of Iranians with 27,111 children and adolescents and their parents. We used a multistage random cluster sampling method. We used Millon Clinical Multiaxial Inventory-Third Edition and Persian present and lifetime version of Kiddie Schedule for Affective Disorders and Schizophrenia to measure parental PDs and children and adolescents' EDs, respectively. We used descriptive statistics and binary logistic regression analysis methods to analyze the data. Maternal but not paternal PDs were significantly associated with EDs in offspring. Maternal antisocial, borderline, schizoid, histrionic, and compulsive PDs were significantly associated with EDs in offspring by 32.06, 4.66, 4.32, 3.15, and 1.71 odd ratios, respectively. Of EDs in offspring, anorexia nervosa and binge ED were significantly associated with maternal PDs.

Do Self-Processes and Parenting Mediate the Effects of Anxious Parents' Psychopathology on Youth Depression and Suicidality?

To understand how anxious parents' global psychopathology increases children's risks for depression and suicidality, we tested mediational pathways through which parent global psychopathology was associated with youth depression and suicidality over a six-year period. Parents (n = 136) who had an anxiety disorder at baseline reported global psychopathology and youth internalizing problems. Youth did not have any psychiatric disorder at baseline and they reported self-esteem, perceived control, and perceived parental warmth and rejection at baseline and 1-year follow-up. At 6-year follow-up, youth depression and suicidality were assessed via multiple reporters including the self, parent, and/or an independent evaluator. Results showed that parental psychopathology had an indirect but not direct effect on youth depression and suicidality via perceived control. No associations were found for the other hypothesized mediators. Perceived control might be a transdiagnostic intervention target in depression and suicide prevention programs for youth exposed to parental anxiety.

Psychiatric comorbidity and familial factors in childhood epilepsy: Parental psychopathology, coping strategies, and family functioning

OBJECTIVE

This study aimed to examine the psychiatric diagnoses, parenting attitudes, family functioning among children and adolescents with epilepsy, coping styles of their mothers, and psychiatric symptoms of their mothers and fathers.

METHODS

Forty children and adolescents between the ages of 8 and 18 with epilepsy and 40 healthy controls were included in the study. The clinical interview and other measurements were used to assess psychiatric disorders and familial factors.

RESULTS

At least one psychiatric disorder was diagnosed in 65% of children and adolescents with epilepsy. It was determined that the mothers and fathers in the epilepsy group had higher anxiety and depression scores than the control group, and the fathers' hostility scores were also higher. The Family Assessment Device (FAD) (problem-solving and affective responsiveness), Coping Strategies Scale (COPE) (mental disengagement and substance use), and Parent Attitude Scale (PAS) (strictness/supervision) subtest scores of the epilepsy group were higher than the control group.

CONCLUSION

Psychiatric comorbidities, especially depression, anxiety disorders, and attention deficit hyperactivity disorder, are more common in children and adolescents with epilepsy. The mental health of parents, parent-child relationships, family functioning, and parental coping styles were adversely affected in families with children with epilepsy. It is essential to evaluate psychiatric comorbidity and family factors in children with epilepsy and to create a treatment plan for problem areas.

Offspring irritability: associations with parental psychopathology and personality

Although there are well-established correlates and outcomes of irritability, there are fewer studies reporting on predictors of the longitudinal course of irritability in youth. The current report examined parent internalizing and externalizing psychopathology and dimensions of personality as predictors of the developmental course of irritability in youth. Offspring irritability was assessed between ages 2 and 10 years using the Irritability Factor from the parent-reported Child Behavior Checklist (N = 570, 53.51% female). Parental psychopathology was assessed with a clinical interview; parents also completed the General Temperament Survey as a measure of personality. Results demonstrated that offspring irritability decreased with age. Offspring irritability was associated with parental depressive and anxiety disorders, higher levels of negative emotionality/neuroticism (NE) and disinhibition, and lower levels of positive emotionality; parental NE and disinhibition remained unique predictors of offspring irritability in a multivariate model. Finally, parental externalizing disorders were associated with more stable trajectories of offspring irritability, whereas offspring of parents without a history of externalizing disorders showed decreasing irritability across time. Findings demonstrate that different aspects of parental personality and psychopathology have differential impacts on levels and course of offspring irritability.

Traumatic events in childhood and adulthood in a diverse-ancestry sample and their role in bipolar disorder

We examined the presence of adverse events in both childhood and adulthood and the prevalence of PTSD in individuals with Bipolar Disorder (BD). There were 191 adults diagnosed with BD Type I and 924 controls, of predominantly African Ancestry (AA). All were administered the GPC-Screening Tool and the BD group the DIPAD. In addition Childhood adversities were measured using the ACE (from 0 to 10), about traumatic events before age 18 and lifetime adversities were measured with 15 questions adapted from the Study of Addiction: Genetics and Environment (A-SAGE (from 0 to 15) for all cases and controls. Probable PTSD (pPTSD) was measured with 4 questions on the GPC screener. Sum scores were calculated for the ACE and A-SAGE by tallying positive responses. Odd Ratios (OR) were used to measure the association between BD and Controls exposure to adversity. BD was associated with a significantly higher mean ACE score and A-SAGE score compared to controls. There was a significantly higher prevalence of pPTSD in the BD (54.5%) versus Controls (6.6%) as well. Greater OR's were seen in the BD compared to Controls for each ACE question (p<0.05). Results were similar for A-SAGE. Limitations include possible recall bias, and missing data.

Preschool-aged children's hair cortisol and parents' behavior, psychopathology, and stress

Parental factors, including parenting behavior, parent mental health, and parent stress, are associated with child stress. More recently, studies have shown that these parental factors may also be associated with children's hair cortisol concentration (HCC). HCC is a novel biomarker for chronic stress. HCC indexes cumulative cortisol exposure thereby reflecting longer-term stress reactivity. Although HCC is associated with a range of problems in adults such as depression, anxiety, appraisal of stressful events, and diabetes, studies investigating HCC in children have been inconsistent, with particularly little information about parental factors and HCC. As chronic stress may have long-term physiological and emotional effects on children, and parent-based interventions can reduce these effects, it is important to identify parental factors that relate to children's HCC. The aim of this study was to examine associations between preschool-aged children's physiological stress measured via HCC and mother- and father-reported parenting behavior, psychopathology, and stress. Participants included N = 140 children ages 3-5-years-old and their mothers (n = 140) and fathers (n = 98). Mothers and fathers completed questionnaire measures on their parenting behavior, depressive and anxiety symptoms, and perceived stress. Children's HCC was assessed by processing small hair samples. HCC levels were higher in boys compared to girls, and higher in children of color compared to white children. There was a significant association between children's HCC and fathers' authoritarian parenting. Children's HCC was positively associated with physical coercion, a specific facet of fathers' authoritarian parenting, even after accounting for sex of the child, race/ethnicity of the child, stressful life events, fathers' depression, fathers' anxiety, and fathers' perceived stress. In addition, there was a significant interaction between higher levels of both mothers' and fathers' authoritarian parenting and children's HCC. Children's HCC was not significantly related to mothers' and fathers' anxiety and depression or mothers' and fathers' perceived stress. These findings contribute to the large literature that links harsh and physical parenting practices with problematic outcomes in children.

Maternal posttraumatic stress predicts Mother-Child Symptom Flare-Ups over Time

Although concurrent associations between parent and child posttraumatic stress symptoms (PTSS) have been well-documented, few longitudinal studies have examined bidirectional influences by modeling the effects of both parent and child PTSS simultaneously over time. The current study examines patterns of PTSS in children and their mothers beginning in preschool and continuing through elementary school age (ages 4-9 years) in a large, heterogeneous sample (N = 331 mother-child dyads). Mothers reported on their own and their child's posttraumatic stress symptoms. A random intercept cross-lagged panel model (RI-CLPM) was used to examine associations between symptoms across six time points. Results indicated that maternal and child symptoms were associated with each other at concurrent time points and tended to fluctuate in a synchronized manner relative to their overall mean symptom levels. Longitudinal cross-lagged paths were significant from mother to child, but non-significant from child to mother, suggesting that mothers' symptom fluctuation at one time point predicted significant fluctuation in children's symptoms at the subsequent time point. The concurrent co-variation of maternal and child symptoms and the predictive nature of maternal symptom flare-ups have important implications for both maternal and child mental health interventions and underscore the importance of attending to mothers' symptomatology early in treatment.

Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder

BACKGROUND

To identify prospectively ascertained individual and family factors that are associated with improvement in Bipolar Disorder (BD) among youths who initially presented with poor course.

METHODS

82 youths with BD with persistent poor mood symptomatology ("predominantly ill course") were compared to 70 youths with BD who at intake had poor course, but showed improvement during the follow-up ("ill with improving course"), (ages 12.3 ± 3.3, vs. 11.7 ± 3.3 years old, at intake). Improvement was measured by the percentage of time euthymic during a mean follow-up of 12.8 years. Youths and parents were interviewed to assess psychopathology, functioning, treatment, and familial functioning and psychopathology.

RESULTS

Compared to the ill group, since intake, the improving group showed significantly lower subthreshold depression and hypo/mania, Attention Deficit Hyperactivity Disorder, and Disruptive Behavior Disorders. Parental Socioeconomic Status (SES) remained unchanged over time in the ill group, but progressively increased in the improving group. Importantly, the change in SES predated the improvement in the mood trajectory. The most influential variables that predicted improvement were higher SES, and absence of parental BD and Substance Use Disorder (SUD). Parental SUD also negatively affected the parental SES, which was directly associated with worse mood course.

LIMITATIONS

Predominantly self-reported White samples may limit generalizability; other factors potentially associated with outcome (e.g., treatment adherence), were not ascertained.

CONCLUSIONS

In addition to treating mood/comorbid psychopathology in symptomatic BD youths, to improve their prognosis, it is crucial to address their parent's BD and SUD and promote parental education/employment.

Parental Psychopathology and Oppositional Defiant Problems in Emerging Adults: Moderated Mediation by Temperament and Gender

Previous studies have indicated that prenatal maternal depressive symptoms predicted toddler temperament, which led to childhood irritability, an important component to ODD problems. In addition, children with ODD problems continue to have difficulties as they transition into emerging adulthood. The current study examined whether present-day emerging adult temperament mediated the relationship between perceived parental psychopathology (e.g., depressive, anxiety, and antisocial problems) and emerging adult ODD problems (e.g., affective and behavioral components). Further, emerging adult and parent gender was examined as a moderator (i.e., moderated mediation). The current study asked a sample of 973 emerging adults to report upon the psychological problems of their parents as well as their own temperament and ODD problems. Negative affect and effortful control mediated the relationship between maternal anxiety problems and female affective and behavioral ODD problems. Similarly, effortful control mediated the relationship between paternal antisocial problems and male behavioral ODD problems. Significant indirect effects occurred for the mother-daughter and father-son dyads only, suggesting moderated mediation by child and parent gender. Thus, temperament may be one process which explains the relationship between parental psychopathology and emerging adult ODD problems, and this process differed by parent and child gender.

Parent's psychopathological profiles and adolescent offspring's substance use disorders

BACKGROUND

Substance use disorders (SUD) represent one of the most important public health problems which has an onset in adolescence. Although substantial data exist on adolescent substance use, studies examining the role of parental psychopathological profiles on adolescent offspring SUD are lacking. Thus, this study aimed to identify parental psychopathological profiles, and to examine the extent to which these profiles are associated with SUD in their offspring.

METHOD

Our analytic sample comprised 5887 adolescents (48.60% boys; M = 15.07 years, SD = 1.46) from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), whose biological parents responded to the Parent Self-Administered Questionnaire. Parental psychopathological profiles were identified by means of latent class analysis.

RESULTS

Different psychopathological profiles were identified in fathers and mothers. Among fathers, two psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use) and "high psychopathology class" (high psychopathological symptoms and drug use). Among mothers, three psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use), "high psychopathology class" (high psychopathological symptoms and drug use), and "suicide class" (low psychopathological symptoms and drug use, but high on suicidal ideation or suicidal attempt). Father's high psychopathology profile was significantly associated with adolescent's illicit drug abuse. Mother's high psychopathology profile was significantly associated with adolescent's nicotine dependence, alcohol or illicit drug abuse.

CONCLUSIONS

Family-based interventions should include skills training in reducing parental SUD and other mental health problems.

Temperament and Affective and Behavioral ODD Problems in Emerging Adults: Moderation by Gender and Perceived Parental Psychopathology

Recent research has indicated that ODD problems persist into emerging adulthood, although mechanisms influencing ODD during emerging adulthood remain relatively unknown. Additionally, temperament and parental psychopathology both are implicated in the development of childhood ODD. Thus, the current study examined how perceived parental (i.e., maternal and paternal) psychopathology (i.e., anxiety, depressive, and antisocial problems) moderated the relationship between temperament (i.e., effortful control, negative affect, and surgency) and ODD problems (i.e., affective and behavioral) in a sample of 599 emerging adults who were instructed to complete questionnaires based on their current perceptions. Results indicated that perceived parental anxiety and antisocial problems moderated the relationship between two of the temperament variables (i.e., negative affect and effortful control) and both types of ODD problems. Moreover, these results were further moderated by participant gender. Finally, perceived parental depressive problems served as a moderator for affective problems only. Overall, results suggest that similar associations found regarding childhood ODD may be implicated when examining emerging adults, and gender moderates these associations.

The impact of parental psychopathology and sociodemographic factors in selective mutism - a nationwide population-based study

BACKGROUND

Selective mutism (SM) is nowadays considered a relatively rare anxiety disorder characterized by children failing to speak in certain situations. Research on risk factors for SM are limited in comparison to other psychiatric disorders. The aim of this study was to examine several potential risk factors for SM in a large nationwide cohort, namely parental psychopathology, parental age, maternal SES, urbanicity, maternal marital status and parental immigration status.

METHODS

This nested case-control study comprised 860 cases with SM, identified from the Finnish Hospital Discharge Register and 3250 controls matched for sex and age from the Finnish Central Population Register. Conditional logistic regression was used to examine the association between the risk factors and SM.

RESULTS

If both parents had any psychiatric disorder, this almost tripled their odds of having a child with SM (OR 2.8, 95% CI 2.0-4.0). There were increased rates of all types of psychiatric disorders in the parents of the children with SM, with a wider range of diagnoses among the mothers than fathers. Fathers over 35 years (OR 1.4, 95% CI 1.1-1.8) were significantly more likely to have children with SM. Offspring of a single mother had a 2-fold (OR = 2.0, 95% CI 1.4-3.0) increased odds of SM than mothers who were married or in a relationship.

CONCLUSIONS

Several parental psychiatric disorders were associated with offspring SM. This points towards a shared aetiology of psychiatric disorders. Findings on paternal age and single motherhood help to improve our understanding of risk factors for SM.

Post-traumatic stress disorder, emotional and behavioral difficulties in children and adolescents 2 years after the 2012 earthquake in Italy: an epidemiological cross-sectional study

Despite the occurrence of several earthquakes, only a few studies were conducted in Italy on the psychological impact in children and adolescents, with data mostly collected within one year after the disaster. This cross-sectional study aimed at exploring the prevalence of both post-traumatic stress disorder (PTSD) and emotional/behavioral difficulties, as well as at identifying their main predictors, among youths 2 years after the earthquake that hit Northern Italy in 2012. 682 children and adolescents (9-14 years) living in two districts (earthquake zone vs control zone) were administered an exposure questionnaire, the UCLA PTSD-Index for DSM-IV, and the Strengths and Difficulties Questionnaire (SDQ) and 1162 parents were assessed through the Symptom Checklist-90 (SCL-90). The prevalence of a likely PTSD in the earthquake zone was 1.9% (4.4% near the epicenter) and the total PTSD score in the affected area was significantly higher than in the control zone. 14.9% of youths living in the earthquake zone had a borderline/abnormal SDQ total difficulties score and 87.5% of youth with a likely PTSD also had a SDQ total score in the borderline/abnormal range. Regression analysis showed that the number of lifetime traumatic events (e.g., death of a relative) was the best predictor of children/adolescents psychological difficulties 2 years after the earthquake, followed by severity of exposure (personal injuries and losses) and parental psychopathology. Despite some limitations, this study highlights that youths may exhibit PTSD symptoms years after disasters, often in comorbidity with behavioral/emotional difficulties, stressing the need for long-term surveillance and interventions in exposed populations.

Child-based treatment of oppositional defiant disorder: mediating effects on parental depression, anxiety and stress

Previous research has shown that child-oppositional defiant disorder (ODD) and conduct disorders (CD) are associated with parental symptoms of depression, anxiety and/or stress, probably in a bidirectional relationship with mutual influences. It is, therefore, reasonable to assume that in child-centered treatment, a decrease in child-oppositional behavior problems constitutes (at least in part) a mechanism of change for a subsequent reduction in parental psychopathology. The aim of the present study (Clinical trials.gov Identifier: NCT01406067) was to examine whether the reduction in ODD symptoms due to child-based cognitive behavioral treatment (CBT) led to a reduction in parental depression, anxiety and stress. Eighty-one boys (age 6-12 years) with a diagnosis of ODD/CD were randomized either to a cognitive behavioral intervention group or an educational play group (acting as control group). Mediation analyses were conducted using path analysis. The stronger reduction in child ODD symptoms in the CBT group compared to the control group led to a decrease in parental depression and stress, as indicated by significant indirect effects (ab = 0.07 and ab = 0.08, p < 0.05). The proposed model for mechanisms of change was, therefore, confirmed for two of the three outcome parameters. Parental psychopathology and stress can be modified by child-centered CBT. The preceding reduction in ODD symptoms acts as a mediator for at least some of the changes in parental depression and stress. However, due to some limitations of the study, other possible explanations for the results found cannot be completely ruled out and are, therefore, discussed.

Associations between Psychopathology in Mothers, Fathers and Their Children: A Structural Modeling Approach

This study investigated associations between parental and child psychopathology with parenting stress as a possible mediator, in order to get more insight in mothers' and fathers' roles in the development of psychopathology in children. Parents of 272 clinically referred (aged 6-20, 66% boys) reported about their own and their child's behavioral problems, and about parenting stress. Data were analyzed using Structural Equation Modeling. Outcomes of path models demonstrated that mothers' higher internalizing and externalizing problems were associated with respectively children's higher internalizing and externalizing problems. Fathers' higher externalizing problems were associated with both children's higher internalizing and externalizing problems, but fathers' internalizing problems were only associated with children's lower externalizing problems. Parenting stress fully mediated the relation between mothers' and children's externalizing problems, and partly mediated the relation between mothers' and children's internalizing problems. For fathers, parenting stress partly mediated the relation between fathers' internalizing problems and children's externalizing problems. Findings indicate that for mothers, the association between parental and child psychopathology is specific, whereas for fathers it is non-specific. Furthermore, results suggest that reducing parenting stress may decrease child problem behavior. Longitudinal studies are needed in order to gain more insight in the direction and underlying mechanisms of the relation between parental and child psychopathology, including parental stress.

Parental psychopathology, adult attachment and risk of 12-month suicidal behaviours

BACKGROUND

The mechanisms by which parental psychopathology and vulnerability to suicide is transmitted to offspring is not well understood. parental psychopathology and behaviour may impact upon the normal emotional and psychological adjustment of their offspring in various ways. Research shows attachment insecurities may also be a key factor in the facilitation of suicidal behaviours.

OBJECTIVE

To examine adult attachment insecurities as a potential mediating pathway between parental psychopathology and 12-month suicidality.

METHOD

The study utilized data from the National co-morbidity Survey-Replication (NCS-R, N = 5692). Parental psychopathology was assessed using items from the Familial History of Psychiatric Disorders section of the NSC-R in conjunction with items designed to capture dimensions of attachment and suicidal behaviours.

RESULTS

Resultant analyses demonstrated specificity effects in that, parental psychopathology was associated with specific suicidal components through specific dimensions of attachment.

DISCUSSION

The results align with literature linking parental psychopathology to both attachment insecurities and risk of suicide. Crucially, this study bridges these research areas by presenting attachment insecurity as possible risk indicator and intervening factor between parental mental health and behaviour and specific indicators of suicide.

Risk factors for parental psychopathology: a study in families with children or adolescents with psychopathology

The parents of children with psychopathology are at increased risk for psychiatric symptoms. To investigate which parents are mostly at risk, we assessed in a clinical sample of families with children with psychopathology, whether parental symptom scores can be predicted by offspring psychiatric diagnoses and other child, parent and family characteristics. Parental depressive, anxiety, avoidant personality, attention-deficit/hyperactivity (ADHD), and antisocial personality symptoms were measured with the Adult Self Report in 1805 mothers and 1361 fathers of 1866 children with a psychiatric diagnosis as assessed in a child and adolescent psychiatric outpatient clinic. In a multivariate model, including all parental symptom scores as outcome variables, all offspring psychiatric diagnoses, offspring comorbidity and age, parental age, parental educational attainment, employment, and relationship status were simultaneously tested as predictors. Both 35.7% of mothers and 32.8% of fathers scored (sub)clinical for at least one symptom domain, mainly depressive symptoms, ADHD symptoms or, only in fathers, avoidant personality symptoms. Parental psychiatric symptoms were predicted by unemployment. Parental depressive and ADHD symptoms were further predicted by offspring depression and offspring ADHD, respectively, as well as by not living together with the other parent. Finally, parental avoidant personality symptoms were also predicted by offspring autism spectrum disorders. In families with children referred to child and adolescent psychiatric outpatient clinics, parental symptom scores are associated with adverse circumstances and with similar psychopathology in their offspring. This signifies, without implying causality, that some families are particularly vulnerable, with multiple family members affected and living in adverse circumstances.

Are Anxiety Disorders in Children and Adolescents Less Impairing Than ADHD and Autism Spectrum Disorders? Associations with Child Quality of Life and Parental Stress and Psychopathology

We compared clinically referred children with anxiety disorders (AD; n = 63) to children with autism spectrum disorder (ASD; n = 39), ADHD Combined (ADHD-C; n = 62), ADHD Predominantly Inattentive (ADHD-I; n = 64), and typically developing children (n = 42) on child quality of life (QOL), paternal and maternal psychopathology and parental stress. Diagnoses were based on DSM-IV-TR criteria. Multilevel analyses showed that QOL in AD was higher on school and social functioning, compared to respectively ADHD and ASD, and lower compared to normal controls on all five domains. Fathers reported their AD children higher QOL than mothers. Also, AD appeared to be associated with less parental stress and parental psychopathology than other child psychopathology. Therefore, parental factors may need to be considered more in treatment of children with ADHD/ASD than AD.

The influence of endophenotypic, disease-specific, and environmental variables on the expression of anxiety in pediatric epilepsy

Children and adolescents with epilepsy often show higher rates of anxiety, which carries an increased risk for reduced health-related quality of life (HRQOL). The current study assessed the role of parental psychiatric history (i.e., anxiety, depression, and/or bipolar disorder) on the rate of anxiety features in youth seen in a tertiary epilepsy clinic. Data included parental ratings on the Behavior Assessment System for Children (BASC-2) and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 180 children and adolescents (mean age=11.40, SD=3.98). Our results identified clinically elevated anxiety ratings in nearly half the sample (47%) with previous psychiatric history endorsed by 48% of parents. The effect of parental psychiatric history on youth anxiety was found to be significant and associated with a threefold increase in the rate of youth anxiety features. This risk increased to fourfold in refractory epilepsy, and the impact of family psychiatric history is greater in adolescent females and in families that report higher levels of stress. In those families who reported no psychiatric history, anxiety was best predicted by epilepsy-specific factors above and beyond sociodemographic factors. Parental psychiatric history was also identified as a significant risk factor for diminished patient HRQOL, even after accounting for seizure control. These findings highlight the impact of family and epilepsy factors on psychological functioning and offer further support for the strong relationship between parental adjustment and child outcome in pediatric epilepsy.

Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children's ADHD.

Hostile parenting, parental psychopathology, and depressive symptoms in the offspring: a 32-year follow-up in the Young Finns study

BACKGROUND

Both hostile parenting and parental psychopathology have been shown to predict depression in the offspring. However, whether and how they interact in predicting the longitudinal course of depression from adolescence to adulthood remains unclear.

METHODS

Participants were from the prospective Cardiovascular Risk in Young Finns study, aged 3-18 years at baseline in 1980. We used multilevel modeling for repeated measurements to examine the associations of hostile parenting (i.e., parental intolerance and emotional distance) and parental history of psychopathology with trajectories of depressive symptoms across five study phases from 1992 to 2012.

RESULTS

On average, depressive symptoms decreased in a curvilinear pattern with age. A relatively steep decreasing trend was also observed among offspring of parents with a history of psychopathology but low intolerance. By contrast, among the offspring of parents with a history of psychopathology and high intolerance there was a rising trend in depressive symptoms starting from young adulthood. There was no similar interaction between parental history of psychopathology, emotional distance, and age.

LIMITATIONS

Non-standardized, parental self-report scales were used to measure hostile parenting. The observed effects were small, and the depressive symptoms scale applied in the study may not be used for measuring clinical depression.

CONCLUSIONS

Parental psychopathology might render individuals sensitive to the unfavorable characteristics of the caregiving environment. Intolerance towards the child can exacerbate the effects of parental psychopathology and have a long-term significance on the developmental trajectory of depressive symptoms over the life-course.

Mindful Parenting Training in Child Psychiatric Settings: Heightened Parental Mindfulness Reduces Parents' and Children's Psychopathology

Mindful parenting training is an application of mindfulness-based interventions that allows parents to perceive their children with unbiased and open attention without prejudgment and become more attentive and less reactive in their parenting. This study examined the effectiveness of mindful parenting training in a clinical setting on child and parental psychopathology and of mindfulness as a predictor of these outcomes. Seventy parents of 70 children (mean age = 8.7) who were referred to a mental health care clinic because of their children's psychopathology participated in an 8-week mindful parenting training. Parents completed questionnaires at pre-test, post-test and 8-week follow-up. A significant decrease was found in children's and parents' psychopathology and a significant increase in mindful parenting and in general mindful awareness. Improvement in general mindful awareness, but not mindful parenting, was found to predict a reduction in parental psychopathology, whereas improvement in mindful parenting, but not general mindful awareness, predicted the reduction of child psychopathology. This study adds to the emerging body of evidence indicating that mindful parenting training is effective for parents themselves and, indirectly, for their children suffering from psychopathology. As parents' increased mindful parenting, but not increased general mindfulness, is found to predict child psychopathology, mindful parenting training rather than general mindfulness training appears to be the training of choice. However, RCTs comparing mindful parenting to general mindfulness training and to parent management training are needed in order to shed more light on the effects of mindful parenting and mechanisms of change.

Parents of children with psychopathology: psychiatric problems and the association with their child's problems

Knowledge is lacking regarding current psychopathology in parents whose children are evaluated in a psychiatric outpatient clinic. This especially accounts for fathers. We provide insight into the prevalence rates of parental psychopathology and the association with their offspring psychopathology by analyzing data on psychiatric problems collected in 701 mothers and 530 fathers of 757 referred children. Prevalence rates of parental psychopathology were based on (sub)clinical scores on the adult self report. Parent-offspring associations were investigated in multivariate analyses taking into account co-morbidity. Around 20 % of the parents had a (sub)clinical score on internalizing problems and around 10 % on attention deficit hyperactivity (ADH) problems. Prevalence rates did not differ between mothers and fathers. Parent-offspring associations did not differ between girls and boys. Maternal anxiety was associated with all offspring problem scores. In addition, maternal ADH problems were associated with offspring ADH problems. Paternal anxiety and ADH problems scores were specifically associated with offspring internalizing and externalizing problem scores, respectively. Associations with offspring psychopathology were of similar magnitude for mothers and fathers and were not influenced by spousal resemblance. Our study shows that both fathers and mothers are at increased risk for psychiatric problems at the time of a child's evaluation and that their problems are equally associated with their offspring problems. The results emphasize the need to screen mothers as well as fathers for psychiatric problems. Specific treatment programs should be developed for these families in especially high need.

Parental and comorbid epilepsy in persons with bipolar disorder

BACKGROUND

Population-based studies have demonstrated an overrepresentation of bipolar disorder (BPD) in individuals with epilepsy. However, few studies have examined the reverse association, i.e. comorbid epilepsy in individuals selected based on BPD diagnosis. No previous population-based study having examined the co-occurrence of BPD and epilepsy has adjusted for parental psychopathology. Such an adjustment is motivated by population-based studies reporting an overrepresentation of various types of parental psychiatric disorders in both BPD and epilepsy. Furthermore, an association between epilepsy in first-degree relatives and BPD has previously only been examined and demonstrated in a small clinical sample. The objective of this study is to examine the associations between parental and comorbid epilepsy and BPD, adjusting for parental psychopathology.

METHODS

This nested case-control study identified 1861 cases with BPD, age up to 25 years, 3643 matched controls, and their parents from Finnish national registers. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) and two-sided significance limits of p<0.05.

RESULTS

BPD was associated with comorbid epilepsy (adjusted OR 2.53, 95% CI: 1.73-3.70) but not with parental epilepsy. Epilepsy was found in 3.33% of cases versus 1.29% of controls, 2.69% of cases' parents versus 2.53% of controls' parents.

LIMITATIONS

The diagnoses were register-based, not based on standardized procedures with direct ascertainment.

CONCLUSIONS

An association between BPD and comorbid epilepsy persists even after adjusting for parental psychopathology. Lack of familial clustering of BPD and epilepsy would suggest that the elevated co-occurrence of these disorders is influenced by non-genetic factors.

Interparental Violence and the Mediating Role of Parental Availability in Children's Trauma Related Symptoms

This cross-sectional study examined the hypothesis that parental psychopathology in Interparental Violence (IPV) families crosses over to children, because parental psychopathology spills over to parental functioning. In a high-risk sample of IPV exposed families, we tested whether parental psychopathology spills over to parental availability, which, in turn, shows a crossover effect to children's trauma-related symptoms. The study population consisted of 78 IPV exposed children (4-12 years), and their 65 custodial parents referred to outpatient Children's Trauma Centers in the Netherlands for intervention. Consistent with our hypotheses, parental psychopathology was negatively related to parental availability, suggesting a spillover effect. Although parental psychopathology was not associated with children's trauma-related symptoms directly, we found evidence for the predicted indirect, crossover effects. We found an indirect crossover effect from parental psychopathology to children's trauma-related anxiety, depression, and anger, through the spillover effect of parental availability. Clinical implications for treatment and study limitations are discussed.

Parental and emerging adult psychopathology: Moderated mediation by gender and affect toward parents

Current research indicates that children tend to view parents with psychopathology more negatively and children who hold negative perceptions of parents are at a greater risk for psychopathology. Yet, less research examines how parental psychopathology influences offspring psychopathology through affect toward parents. The current study tested a model that examined the associations among parental psychopathology, positive affect toward parents, and emerging adult psychopathology. Associations were expected to be partly indirect via positive affect toward parents and emerging adult gender was expected to moderate these associations. Results indicated gender-moderated mediation with significant effects found for males but not females. Results from the current study emphasize the importance of examining affect toward parents as a risk factor for emerging adult psychopathology. Additionally, results of the current study demonstrate the importance of examining the role of emerging adult gender as a potential moderator in these relationships.

Adult offspring perspectives on parental hoarding behaviors

Hoarding disorder (HD) is characterized by difficulty discarding unneeded items and the accumulation of items within living spaces and is associated with significant functional impairment and distress. Along with the negative impact of hoarding on the individual, HD is substantially impairing for family members, and linked to disruptions in family functioning. The present study utilized a path model analysis to examine the associations between an array of hoarding variables hypothesized to impact family functioning and parent-offspring relationships in 150 adult-aged children of hoarders who responded to online requests to participate in a research study. It was hypothesized that increased hoarding severity, decreased insight, and increased family accommodation (i.e., act of family members facilitating or assisting in hoarding behaviors) would be associated with decreased family functioning, decreased quality of parent-offspring relationships, and increased offspring impairment. Results from the path model revealed that family functioning mediated the relationship between hoarding severity and parent-offspring relationship. Diminished insight in the hoarding parent (as reported by the offspring) was associated with increased familial conflict and family functioning partially mediated the relationship between insight and quality of parent-offspring relationship. Increased family accommodation was significantly associated with increased impairment (work, social, and family domains) in offspring of hoarders.

Parental psychopathology moderates the influence of parental divorce on lifetime alcohol use disorders among Israeli adults

BACKGROUND

Parental divorce and psychopathology are well-documented risk factors for alcohol use disorders (AUD) in the United States and other countries where divorce is common and per capita total alcohol consumption is moderate to high. However, little is known about these relationships in countries where divorce and alcohol problems are less common, such as Israel.

METHODS

Israeli adult household residents (N=797) age 21-45 were interviewed in person between 2007 and 2009. Logistic regression models were used to examine main and additive interaction effects of parental divorce and psychopathology on lifetime DSM-IV AUD, adjusting for age, gender, and ethnicity.

RESULTS

Parental divorce (OR=2.18, p≤0.001) and parental psychopathology (OR=1.61, p≤0.01) were independently associated with lifetime AUD and, when considered together, showed significant interaction (p=0.026). Specifically, the effect of divorce on AUD was only significant among those who also reported parental psychopathology.

CONCLUSIONS

This is the first study showing the influence of parental divorce and psychopathology on risk for AUD among Israeli adults, where both divorce and AUD are less common than in the United States. Alcohol prevention and treatment professionals should recognize that children who experience parental divorce and/or psychopathology could be more vulnerable to later developing AUD than those whose parents remain together and without psychopathology.

Correction of distortion in distressed mothers' ratings of their preschool-aged children's Internalizing and Externalizing scale score

Increased maternal psychopathology may bias mothers' ratings about child psychopathology. In this study we examined whether internalizing and externalizing behavior problems in young children were biased through maternal psychopathology. The clinical sample comprised 247 preschool-age patients who attended the Family Day Hospital in Münster, Germany. Internalizing and externalizing behavior problems were assessed by the CBCL/1.5-5, and maternal psychopathology was assessed by the SCL-90-R Global Severity Index (GSI). Three theoretical perspectives were tested by comparing the model fit of three structural equation models, namely the accuracy, distortion, and combinatory model. All of the models aimed to integrate multi-informant ratings from mother, therapists, and kindergarten teachers, but differed in the question which paths had to be significant. The distortion model fit the data best and supported the notion that there was a psychopathology-related bias in mothers' ratings. On the basis of this finding, we developed correction formulas comparable to Müller and Furniss (2013), in order to statistically control for this distortion. We discussed post-hoc explanations about why mothers with increased psychopathology gave higher ratings on the CBCL/1.5-5, including a better recall of internalizing symptoms, less flexible and effective parenting, and more perceived distress by child externalizing behavior.

Correction of distortions in distressed mothers' ratings of their preschool children's psychopathology

The often-reported low informant agreement about child psychopathology between multiple informants has lead to various suggestions about how to address discrepant ratings. Among the factors that may lower agreement that have been discussed is informant credibility, reliability, or psychopathology, which is of interest in this paper. We tested three different models, namely, the accuracy, the distortion, and an integrated so-called combined model, that conceptualize parental ratings to assess child psychopathology. The data comprise ratings of child psychopathology from multiple informants (mother, therapist and kindergarten teacher) and ratings of maternal psychopathology. The children were patients in a preschool psychiatry unit (N=247). The results from structural equation modeling show that maternal ratings of child psychopathology were biased by maternal psychopathology (distortion model). Based on this statistical background, we suggest a method to adjust biased maternal ratings. We illustrate the maternal bias by comparing the ratings of mother to expert ratings (combined kindergarten teacher and therapist ratings) and show that the correction equation increases the agreement between maternal and expert ratings. We conclude that this approach may help to reduce misclassification of preschool children as 'clinical' on the basis of biased maternal ratings.