Background: Parental mental illness has a negative impact on children’s mental health. Often, the entire family structure suffers from the consequences of parental illness. Purpose: For future interventions, it is important to examine the impact of specific factors such as parental symptom severity on children’s mental health and family functioning. Method: The sample of this study included N = 203 parents with mental illness with a total of N = 309 children. Parents completed questionnaires on symptom severity. Children’s mental health symptoms were rated by parents and children and family functioning was assessed from the children’s perspective. Results: Mixed linear models showed a significant impact of parental symptom severity on children’s mental health from both parents’ and children’s perspectives. No significant impact of symptom severity on perceived family functioning from the children’s perspective was found. Conclusion: Results underline the importance of personalized interventions in terms of parental symptom severity to minimize negative outcomes for children and the whole family.
References
[1]
Achenbach, T. M., & Edelbrock, C. (1991). Manual for Child Behavior Checklist 4-18, 1991 Profile. Department of Psychiatry, University of Vermont.
[2]
Axelson, D., Goldstein, B., Goldstein, T., Monk, K., Yu, H., Hickey, M. B. et al. (2015). Diagnostic Precursors to Bipolar Disorder in Offspring of Parents with Bipolar Disorder: A Longitudinal Study. American Journal of Psychiatry, 172, 638-646. https://doi.org/10.1176/appi.ajp.2014.14010035
Bartsch, D. R., Roberts, R., & Proeve, M. (2022). Relationships between Parental Borderline Symptom Severity, Empathy, Parenting Styles and Child Psychopathology. Clinical Psychologist, 26, 211-221. https://doi.org/10.1080/13284207.2022.2031947
[5]
Benninghoven, D., Cierpka, M., & Thomas, V. (2008). überblick über Familiendiagnostische Fragebogeninventare. In M. Cierpka (Ed.), Handbuch der Familiendiagnostik (pp. 427-446). Springer. https://doi.org/10.1007/978-3-540-78475-3_24
[6]
Berg-Nielsen, T. S., Vika, A., & Dahl, A. A. (2003). When Adolescents Disagree with Their Mothers: CBCL-YSR Discrepancies Related to Maternal Depression and Adolescent Self-Esteem. Child: Care, Health and Development, 29, 207-213. https://doi.org/10.1046/j.1365-2214.2003.00332.x
[7]
Cierpka, M., & Frevert, G. (1995). Die Familienbogen. Ein Inventar zur Einschätzung von Familienfunktionen. Hogrefe.
[8]
Derogatis, L. R. (1992). SCL-90-R: Administration, Scoring & Procedures Manual-II for the (Revised) Version and Other Instruments of the Psychopathology Rating Scale Series (pp. 1-16). Clinical Psychometric Research.
[9]
Döpfner, M., Berner, W., & Lehmkuhl, G. (1995). Reliability and Factorial Validity of the Youth Self-Report of the Child Behavior Checklist in a Clinical Sample. Diagnostica, 41, 221-244.
[10]
El-Sheikh, M., & Kelly, R. J. (2017). Family Functioning and Children’s Sleep. Child Development Perspectives, 11, 264-269. https://doi.org/10.1111/cdep.12243
Eyden, J., Winsper, C., Wolke, D., Broome, M. R., & MacCallum, F. (2016). A Systematic Review of the Parenting and Outcomes Experienced by Offspring of Mothers with Borderline Personality Pathology: Potential Mechanisms and Clinical Implications. Clinical Psychology Review, 47, 85-105. https://doi.org/10.1016/j.cpr.2016.04.002
[13]
Field, A. (2009). Discovering Statistics Using IBM SPSS Statistics (Band 3). SAGE.
[14]
Franke, G. H. (2000). Brief Symptom Inventory (BSI) von LR Derogatis: (Kurzform der SCL-90-R). Beltz Test.
[15]
Freed, R. D., Tompson, M. C., Wang, C. H., Otto, M. W., Hirshfeld-Becker, D. R., Nierenberg, A. A., & Henin, A. (2015). Family Functioning in the Context of Parental Bipolar Disorder: Associations with Offspring Age, Sex, and Psychopathology. Journal of Family Psychology, 29, 108-118. https://doi.org/10.1037/fam0000048
[16]
Hammen, C., & Brennan, P. A. (2003). Severity, Chronicity, and Timing of Maternal Depression and Risk for Adolescent Offspring Diagnoses in a Community Sample. Archives of General Psychiatry, 60, 253-258. https://doi.org/10.1001/archpsyc.60.3.253
[17]
Heradstveit, O., Haugland, B. S. M., Nilsen, S. A., Bøe, T., Sivertsen, B., & Hysing, M. (2021). Parental Mental Illness as a Risk Factor for Adolescent Psychiatric Disorders: A Registry-Based Study of Specialized Child and Adolescent Health Services. Child & Youth Services. https://doi.org/10.1080/0145935X.2021.1997584
[18]
Holtmann, S. C., Kranert, H.-W., & Stein, R. (2020). Der Einsatz des Youth Self Report (YSR/11-18) bei Heranwachsenden. Eine faktorenanalytische Betrachtung im Kontext der Beruflichen Bildung. Empirische Sonderpädagogik, 12, 3-26.
[19]
Jacobs, R. H., Talati, A., Wickramaratne, P., & Warner, V. (2015). The Influence of Paternal and Maternal Major Depressive Disorder on Offspring Psychiatric Disorders. Journal of Child and Family Studies, 24, 2345-2351. https://doi.org/10.1007/s10826-014-0037-y
[20]
Klasen, H., Woerner, W., Wolke, D., Meyer, R., Overmeyer, S., Kaschnitz, W., Rothenberger, A., & Goodman, R. (2000). Comparing the German Versions of the Strengths and Difficulties Questionnaire (SDQ-Deu) and the Child Behavior Checklist. European Child & Adolescent Psychiatry, 9, 271-276. https://doi.org/10.1007/s007870070030
[21]
Koutra, K., Triliva, S., Roumeliotaki, T., Basta, M., Simos, P., Lionis, C., & Vgontzas, A. N. (2015). Impaired Family Functioning in Psychosis and Its Relevance to Relapse: A Two-Year Follow-up Study. Comprehensive Psychiatry, 62, 1-12. https://doi.org/10.1016/j.comppsych.2015.06.006
[22]
Leijdesdorff, S., van Doesum, K., Popma, A., Klaassen, R., & van Amelsvoort, T. (2017). Prevalence of Psychopathology in Children of Parents with Mental Illness and/or Addiction: An up to Date Narrative Review. Current Opinion in Psychiatry, 30, 312-317. https://doi.org/10.1097/YCO.0000000000000341
[23]
Letourneau, N. L., Tramonte, L., & Willms, J. D. (2013). Maternal Depression, Family Functioning and Children’s Longitudinal Development. Journal of Pediatric Nursing, 28, 223-234. https://doi.org/10.1016/j.pedn.2012.07.014
[24]
Lewandowski, A. S., Palermo, T. M., Stinson, J., Handley, S., & Chambers, C. T. (2010). Systematic Review of Family Functioning in Families of Children and Adolescents with Chronic Pain. The Journal of Pain, 11, 1027-1038. https://doi.org/10.1016/j.jpain.2010.04.005
[25]
Lutz, W., Clausen, S. A., & Deisenhofer, A.-K. (2019). Perspektiven Einer Evidenzbasierten und Personalisierten Psychotherapie. Zeitschrift für Klinische Psychologie und Psychotherapie, 48, 79-89. https://doi.org/10.1026/1616-3443/a000518
[26]
Mars, B., Collishaw, S., Smith, D., Thapar, A., Potter, R., Sellers, R., Harold, G. T., Craddock, N., Rice, F., & Thapar, A. (2012). Offspring of Parents with Recurrent Depression: Which Features of Parent Depression Index Risk for Offspring Psychopathology? Journal of Affective Disorders, 136, 44-53. https://doi.org/10.1016/j.jad.2011.09.002
[27]
McGrath, J. J., Petersen, L., Agerbo, E., Mors, O., Mortensen, P. B., & Pedersen, C. B. (2014). A Comprehensive Assessment of Parental Age and Psychiatric Disorders. JAMA Psychiatry, 71, 301-309. https://doi.org/10.1001/jamapsychiatry.2013.4081
[28]
McLaughlin, K. A., Gadermann, A. M., Hwang, I., Sampson, N. A., Al-Hamzawi, A., Andrade, L. H., Angermeyer, M. C., Benjet, C., Bromet, E. J., & Bruffaerts, R. (2012). Parent Psychopathology and Offspring Mental Disorders: Results from the WHO World Mental Health Surveys. The British Journal of Psychiatry, 200, 290-299. https://doi.org/10.1192/bjp.bp.111.101253
[29]
National Institute of Mental Health (1996). CGI: Clinical Global Impressions (Band 12, 218-222). National Institute of Mental Health.
[30]
Otto, C., Haller, A.-C., Klasen, F., Hölling, H., Bullinger, M., Ravens-Sieberer, U., & Group, B. S. (2017). Risk and Protective Factors of Health-Related Quality of Life in Children and Adolescents: Results of the Longitudinal BELLA Study. PLOS ONE, 12, e0190363. https://doi.org/10.1371/journal.pone.0190363
[31]
Pérez, J. C., Coo, S., & Irarrázaval, M. (2018). Is Maternal Depression Related to Mother and Adolescent Reports of Family Functioning? Journal of Adolescence, 63, 129-141. https://doi.org/10.1016/j.adolescence.2017.12.013
[32]
Piersma, H. L., & Boes, J. L. (1995). Agreement between Patient Self-Report and Clinician Rating: Concurrence between the Bsi and the Gap among Psychiatric Inpatients. Journal of Clinical Psychology, 51, 153-157. https://doi.org/10.1002/1097-4679(199503)51:2<153::AID-JCLP2270510203>3.0.CO;2-Z
[33]
Plass, A., Haller, A.-C., Habermann, K., Barkmann, C., Petermann, F., Schipper, M., Wiegand-Grefe, S., Hölling, H., Ravens-Sieberer, U., & Klasen, F. (2016). Faktoren der Gesunderhaltung bei Kindern psychisch belasteter Eltern. Kindheit und Entwicklung, 25, 41-49. https://doi.org/10.1026/0942-5403/a000187
[34]
Plass-Christl, A., Haller, A.-C., Otto, C., Barkmann, C., Wiegand-Grefe, S., Hölling, H., Schulte-Markwort, M., Ravens-Sieberer, U., & Klasen, F. (2017). Parents with Mental Health Problems and Their Children in a German Population Based Sample: Results of the BELLA Study. PLOS ONE, 12, e0180410. https://doi.org/10.1371/journal.pone.0180410
[35]
Reupert, A. E., Cuff, R., Drost, L., Foster, K., Van Doesum, K. T., & Van Santvoort, F. (2013). Intervention Programs for Children Whose Parents Have a Mental Illness: A Review. Medical Journal of Australia, 199, S18-S22. https://doi.org/10.5694/mja11.11145
[36]
Sell, M., Barkmann, C., Adema, B., Daubmann, A., Kilian, R., Stiawa, M. et al. (2021a). Associations of Family Functioning and Social Support with Psychopathology in Children of Mentally Ill Parents: Multilevel Analyses from Different Rating Perspectives. Frontiers in Psychology, 12, Article 705400. https://doi.org/10.3389/fpsyg.2021.705400
[37]
Sell, M., Daubmann, A., Zapf, H., Adema, B., Busmann, M., Stiawa, M., Winter, S. M., Lambert, M., Wegscheider, K., & Wiegand-Grefe, S. (2021b). Family Functioning in Families Affected by Parental Mental Illness: Parent, Child, and Clinician Ratings. International Journal of Environmental Research and Public Health, 18, Article No. 7985. https://doi.org/10.3390/ijerph18157985
[38]
Sell, M., Radicke, A., Adema, B., Daubmann, A., Kilian, R., Stiawa, M. et al. (2021c). Parents with Mental Illness: Parental Coping Behavior and Its Association with Children’s Mental Health. Frontiers in Psychiatry, 12, Article 737861. https://doi.org/10.3389/fpsyt.2021.737861
[39]
Steinhauer, P. D., Santa-Barbara, J., & Skinner, H. (1984). The Process Model of Family Functioning. The Canadian Journal of Psychiatry, 29, 77-88. https://doi.org/10.1177/070674378402900202
[40]
Sweeney, S., & MacBeth, A. (2016). The Effects of Paternal Depression on Child and Adolescent Outcomes: A Systematic Review. Journal of Affective Disorders, 205, 44-59. https://doi.org/10.1016/j.jad.2016.05.073
[41]
van Santvoort, F., Hosman, C. M., van Doesum, K. T., & Janssens, J. M. (2013). Children of Mentally Ill or Addicted Parents Participating in Preventive Support Groups. International Journal of Mental Health Promotion, 15, 198-213. https://doi.org/10.1080/14623730.2013.851816
[42]
Waldmann, T., Stiawa, M., Dinc, ü., Saglam, G., Busmann, M., Daubmann, A. et al. (2021). Costs of Health and Social Services Use in Children of Parents with Mental Illness. Child and Adolescent Psychiatry and Mental Health, 15, 1-11. https://doi.org/10.1186/s13034-021-00360-y
[43]
Wang, J., Chen, Y., Tan, C., & Zhao, X. (2016). Family Functioning, Social Support, and Quality of Life for Patients with Anxiety Disorder. International Journal of Social Psychiatry, 62, 5-11. https://doi.org/10.1177/0020764015584649
[44]
Weissman, M. M., Wickramaratne, P., Gameroff, M. J., Warner, V., Pilowsky, D., Kohad, R. G., Verdeli, H., Skipper,J., & Talati, A. (2016). Offspring of Depressed Parents: 30 Years Later. American Journal of Psychiatry, 173, 1024-1032. https://doi.org/10.1176/appi.ajp.2016.15101327
[45]
Wiegand-Grefe, S., Filter, B., Busmann, M., Kilian, R., Kronmüller, K.-T., Lambert, M. et al. (2021). Evaluation of a Family-Based Intervention Program for Children of Mentally Ill Parents: Study Protocol for a Randomized Controlled Multicenter Trial. Frontiers in Psychiatry, 11, Article 61790. https://doi.org/10.3389/fpsyt.2020.561790
[46]
Wiegand-Grefe, S., Geers, P., Petermann, F., & Plass, A. (2011). Kinder Psychisch Kranker Eltern: Merkmale Elterlicher Psychiatrischer Erkrankung und Gesundheit der Kinder aus Elternsicht. Fortschritte der Neurologie• Psychiatrie, 79, 32-40. https://doi.org/10.1055/s-0029-1245623
[47]
Wiegand-Grefe, S., Geers, P., Plaß, A., Petermann, F., & Riedesser, P. (2009). Kinder Psychisch Kranker Eltern: Zusammenhänge Zwischen Subjektiver Elterlicher Beein-trächtigung und Psychischer Auffälligkeit der Kinder aus Elternsicht. Kindheit und Entwicklung, 18, 111-121. https://doi.org/10.1026/0942-5403.18.2.111
[48]
Wiegand-Grefe, S., Sell, M., Filter, B., & Plass-Christl, A. (2019). Family Functioning and Psychological Health of Children with Mentally Ill Parents. International Journal of Environmental Research and Public Health, 16, Article 1278. https://doi.org/10.3390/ijerph16071278
[49]
World Health Organization (2019). ICD 10: International Statistical Classification of Diseases and Related Health Problems: Tenth Revision. World Health Organization.
