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Correlates of Adolescent-reported and Parent-reported Family Conflict Among Canadian Adolescents With Bipolar Disorder

TIMMINS, VANESSA; SWAMPILLAI, BRENDA; HATCH, JESSICA; SCAVONE, ANTONETTE; COLLINGER, KATELYN, MA; BOULOS, CAROLYN, MD; GOLDSTEIN, BENJAMIN I., MD, PhD

Journal of Psychiatric Practice®: January 2016 - Volume 22 - Issue 1 - p 31–41
doi: 10.1097/PRA.0000000000000118
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Background: Family conflict exacerbates the course of bipolar disorder (BP) among adults. However, few studies have examined family conflict among adolescents with BP, and fewer have looked at adolescent-reported and parent-reported family conflict separately.

Methods: Subjects were 89 adolescents, aged 13 to 19 years, with a diagnosis of BP on the basis of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (KSADS-PL). Subjects were divided into high-conflict and low-conflict groups using a median split on the Conflict Behavior Questionnaire (child report and parent report). The χ2 analyses and independent samples t tests were performed for univariate analyses. Multivariable logistic regression analyses were performed on variables with P<0.2.

Results: Parent-reported and adolescent-reported Conflict Behavior Questionnaire scores were significantly correlated (r=0.50, P<0.001). High parent-reported family conflict was positively associated with recent manic symptoms, externalizing comorbidities, and dimensional scores reflecting emotional dysregulation. High adolescent-reported family conflict was positively associated with recent manic symptoms and emotional dysregulation, and negatively associated with socioeconomic status and lifetime psychiatric hospitalization. Bipolar subtype was significantly associated with high versus low family conflict.

Limitations: The limitations of this study included being a cross-sectional study, use of a medium-sized sample, and lack of a control group.

Conclusions: Despite substantial agreement between adolescents and parents regarding the amount of family conflict, there were meaningful differences in the factors associated with adolescent-reported and parent-reported conflict. These findings demonstrate the importance of ascertaining family conflict from adolescents as well as from parents. Moreover, these findings can potentially inform family therapy, which is known to be effective for adolescents with BP.

TIMMINS, SWAMPILLAI, HATCH, SCAVONE, COLLINGER, BOULOS, and GOLDSTEIN: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Supported by Canadian Institutes of Health Research, Heart & Stroke Foundation of Ontario, Ontario Mental Health Foundation, and anonymous donations

B.I.G. has received honoraria from Purdue Pharma in the past and has previously been a consultant for Bristol-Myers Squibb. The other authors declare no conflicts of interest.

Please send correspondence to: Benjamin I. Goldstein, MD, PhD, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON, Canada M4N 3M5 (e-mail: benjamin.goldstein@sunnybrook.ca).

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.