Family Functioning and the Course of Adolescent Bipolar Disorder

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age = 14.48 ± 1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents’ depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents’ manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.     

Acculturation, parent-adolescent conflict, and adolescent adjustment in Mexican American families

We tested an acculturation model in a community sample of Mexican American families (146 mothers, 137 fathers, and 146 adolescents) that proposed that differences between parents and adolescents in acculturation would be associated with parent-adolescent conflict and adolescent adjustment problems. Contrary to hypotheses, we found that families who exhibited an acculturation gap were not more likely to report parent-adolescent conflict or adolescent adjustment problems. In fact, familial conflict and adolescent sexual experience were associated with high levels of acculturation among adolescents and their parents. Pending replication, these findings suggest that both parent and children acculturation may independently predict familial processes and youth outcomes, irrespective of an acculturation gap. Future research should consider other factors aside from acculturation differences that might account for parent-adolescent conflict and adolescent adjustment in Mexican American families.     

Family structure and family processes in Mexican-American families

Despite increases in single-parent families among Mexican Americans, few studies have examined the association of family structure and family adjustment. Utilizing a diverse sample of 738 Mexican-American families (21.7% single parent), the current study examined differences across family structure on early adolescent outcomes, family functioning, and parent-child relationship variables. Results revealed that early adolescents in single-parent families reported greater school misconduct, conduct disorder/oppositional deviant disorder, and major depressive disorder symptoms, and greater parent-child conflict than their counterparts in 2-parent families. Single-parent mothers reported greater economic hardship, depression, and family stress. Family stress and parent-child conflict emerged as significant mediators of the association between family structure and early adolescent outcomes, suggesting important processes linking Mexican-American single-parent families and adolescent adjustment.     

Unfolding Relations among Mindful Parenting,Recurrent Conflict,and Adolescents’ Externalizing and Internalizing Problems

The current study examined unfolding relations among mothers’ mindful parenting, parent–adolescent recurrent conflict, and adolescents’ externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2–3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent–adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.     

Witnessed community violence and antisocial behavior in high-risk, urban boys

Examined the longitudinal relation between children's self-report of witnessing community violence, family environment, and parent report of child antisocial behavior in a sample of 6- to 10-year-old urban American boys (N = 97) at familial risk for antisocial behavior. Boys reported high rates of lifetime exposure to community violence. Boys' reports of witnessing community violence were significantly positively related to changes over 15 months in child antisocial behavior, even after controlling for the possible effects of 3 aspects of parent-child interactions shown previously to be related to problematic child behavior. Furthermore, family environment, particularly the degree to which parents engaged in conflict with their sons, moderated the effect of witnessed violence on changes in antisocial behavior. In families with low conflict, higher levels of witnessed violence predicted increases in antisocial behavior over time. In contrast, in families with relatively high levels of parent-child conflict, high-witnessed violence had no additional influence on antisocial outcome. This is the first prospective longitudinal study to document an association between witnessed community violence and changes in antisocial behavior in young, urban boys at familial risk for antisocial behavior.     

Parent-Offspring Transmission of Internalizing and Sensory over-Responsivity Symptoms in Adolescence

Reactions to sensory experiences are an overlooked correlate of affective regulation, despite the importance of bodily states on psychological processes. Children who display sensory over-responsivity (i.e., adverse reactions to typical sensations) are at greater risk for developing affective disorders. We extended this literature to adolescents and their middle-aged parents. Participants in a birth record-based study of families of adolescent twins (N = 506 families; 1012 adolescents; 53% female) completed a subset of items from the Adult Sensory Profile. We derived adolescent self-reported internalizing disorder symptoms and parent affective diagnoses from structured diagnostic interviews. Structural equation models tested the relationship between parent sensory over-responsivity symptoms and affective diagnoses and their adolescent offspring’s sensory over-responsivity and internalizing symptoms. Adolescent sensory over-responsivity symptoms were correlated with internalizing disorder symptoms. Parents with a diagnosis of anxiety or depression (mothers only) reported more frequent SOR symptoms than parents without a diagnosis. Parent depression was significantly related to adolescent sensory over-responsivity symptoms, over and above parent sensory over-responsivity symptoms (β = 0.26, p < 0.001 for mothers; β = 0.13, p = 0.004 for fathers). Father alcohol abuse/dependency also predicted offspring sensory over-responsivity symptoms. Offspring of parents with affective disorders were at additional risk for sensory dysregulation via parents’ influence on offspring internalizing problems.     

Adolescent Adjustment to Perceived Marital Conflict

The cognitive-contextual framework of Grych and Fincham (1990) and the emotional-security framework of Davies and Cummings (1994) were used to explore both the direct and indirect pathways between marital conflict and adolescent adjustment. Two hundred and three non-clinic adolescents (114 females and 89 males) from intact families completed self-report questionnaires concerning their adjustment behavior, perceptions of parental conflict, and attachment to parents and peers. Marital conflict was found to have a direct effect upon adolescent adjustment, with adolescents from high-conflict homes displaying greater adjustment difficulties. Indirect effects of conflict were evident through both the adolescents' cognitive appraisals of conflict, and the adolescents' perceptions of the parent-child relationship. Differential gender effects were obtained, highlighting the importance of adolescent gender as a mediating variable. These findings were used to propose that an integrated, cognitive-emotional framework might be necessary to fully understand the conflict/adjustment relationship.     

Exploring Processes in Day-to-Day Parent–Adolescent Conflict and Angry Mood: Evidence for Circular Causality

Parent–adolescent conflict has been studied both as a precursor of long-term macrolevel developmental risks and as an outcome of microlevel, moment-to-moment interaction patterns. However, the family-level processes underlying the maintenance or regulation of conflict in daily life are largely overlooked. A meso-level understanding of parent–adolescent conflict offers important practical insights that have direct implications for interventions. The present study explores day-to-day reciprocal processes and carryover in parents’ and adolescents’ experiences of anger and conflict. Daily diary data provided by parent–adolescent dyads (N = 151) from two-caregiver households (adolescents: 61.59% female, mean age = 14.60 years) over 21 days were examined using a multivariate Poisson multilevel model to evaluate the circular causality principle in parents’ and adolescents’ daily conflict and anger. Findings offer empirical support for the theory, suggesting that parents’ and adolescents’ anger and conflict exist together in a feedback loop wherein conflict is both a consequence of past anger and also an antecedent of future anger, both within and across persons. Increased understanding of the daily interaction patterns and maintenance of parent–adolescent conflict can guide more informed, targeted, and well-timed interventions intended to ameliorate the consequences of problematic parent–adolescent conflict sequences.     

A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder

Impairments in family functioning are associated with more severe depressive and manic symptoms, earlier recurrences, and more suicidal behaviors in early-onset bipolar disorder. This study examined whether family-focused treatment for adolescents (FFT-A) with BD I or II disorder led to greater increases in family cohesion and adaptability and decreases in conflict over 2 years compared to a briefer psychoeducational treatment (enhanced care, EC). Participants were 144 adolescents (mean age: 15.6 ± 1.4 years) with BD I or II with a mood episode in the previous 3 months. Adolescents and parents were randomized to either FFT-A (21 sessions) or EC (three sessions). Patients received guideline-based pharmacotherapy throughout the 2-year study. Trajectories of adolescent- and parent-rated family cohesion, adaptability, and conflict were analyzed over 2 years. FFT-A had greater effects on adolescent-rated family cohesion compared to EC over 2 years. Participants in FFT-A and EC reported similar improvements in family conflict across the 2 years. In the FFT-A group, low-conflict families had greater adolescent-rated family cohesion throughout the study compared to high-conflict families. High-conflict families in both treatment groups tended to show larger reductions in conflict over 2 years than low-conflict families. Family psychoeducation and skills training may improve family cohesion in the early stages of BD. Measuring levels of family conflict at the start of treatment may inform treatment responsiveness among those receiving FFT-A.     

父母冲突、青少年应对策略及其与青少年社会适应的关系

以736名小学、初中、高中学生为被试,着重探讨了父母冲突内容、青少年应对策略和青少年社会适应之间的关系。研究发现:(1)父母冲突中指向孩子和指向父母自身的冲突普遍较少,但指向孩子的冲突显著地多于指向父母自身的冲突。指向孩子的冲突存在显著的性别和年级主效应;(2)青少年所使用的间接应对策略要显著地多于直接应对策略,直接应对和间接应对策略均存在显著的性别和年级主效应;(3)青少年的不良行为存在显著的性别主效应,学习问题、抑郁和主观幸福感存在显著的年级主效应;(4)父母冲突多的青少年和使用应对策略少的青少年出现的不良行为、学习问题和抑郁要显著地高于父母冲突少、使用应对策略多的青少年,但前者感受到的主观幸福感要显著地少于后者;(5)指向孩子的冲突和直接应对策略可以显著地预测青少年的不良行为,指向孩子和指向父母自身的冲突可以显著地预测青少年的学习问题。间接应对策略和指向父母自身的冲突可以显著地预测青少年的抑郁情绪,同时,间接应对策略可以显著地影响青少年的主观幸福感。     

Predicting adolescents' parent–child relationship quality from parental personality,marital conflict and adolescents' personality

Longitudinal influences on the relationships between parents and their adolescent children in 175 Austrian families were analysed with data from three measurement points over a time span of 18 years. We investigated the influences of parental personality, marital conflict and adolescents' personality on the father–child and mother–child relationships separately. Inconsistent with previous theories and empirical findings, we found almost no associations between parental personality and parent–child relationships. Marital conflict was associated with only the father–child relationship. Children's personality showed the most consistent associations with the parent–child relationship. Our data support the theory of dynamic interactionism, which postulates an interdependency of personality factors and social relationships.     

Parental conflict and male adolescent problem behavior.

Mothers in 30 clinical and 35 nonclinical families completed a behavior checklist for a target son and all other sons in the family who were between 13 and 17 years old. Each of these male adolescents completed two perceived parental conflict questionnaires for their biological parents. In each group, child behavior problems and parental conflict were correlated under two conditions: (a) using information pertaining to the target adolescent and (b) using information pertaining to the male adolescent experiencing the greatest behavior difficulties. Correlations increased in the nonclinical group when the information used was for the adolescent experiencing the greatest behavior difficulties.     

Growing Up in Violent Communities: Do Family Conflict and Gender Moderate Impacts on Adolescents’ Psychosocial Development?

This study examined the moderating effects of family conflict and gender on the relationship between community violence and psychosocial development at age 18. The study sample consisted of 728 children and families who were part of the Infant Health and Development Program study of low-birth-weight, pre-term infants. In this sample, adolescent psychosocial outcomes were predicted by community violence differently for male and female children and based on their experiences of conflict at home. For male children, being in a high conflict family as a child exacerbated the negative effects of community violence such that internalizing problems (depression and anxiety) and risk-taking behaviors increased as community violence increased, while being in a low conflict family protected the child against the negative impacts of the community. For female adolescents, there were no moderating effects of family conflict on the relationship between community violence and externalizing problems. Moderating effects for internalizing problems demonstrated that being in low conflict families did not serve as protection against community violence for girls as was demonstrated for boys. These findings demonstrate the long-term effects of community violence on child development, highlighting the importance of gender and family context in the development of internalizing and externalizing problems.     

The Differential Impact of Parental Warmth on Externalizing Problems Among Triangulated Adolescents

Triangulation is a family-wide process in which children are inappropriately involved in interparental conflict, placing them at heightened risk for adjustment problems. A common form of triangulation occurs by parents pressuring their children to take sides, which may result in feelings of being torn between parents. Externalizing behaviors in particular may develop as adolescents feel caught in the middle of conflict and forced to choose a side. However, the nature of the triadic process of triangulation may be impacted by dyadic-level relationships within the family. The authors thus explored how positive parenting processes may alter the relations between triangulation and adolescent externalizing problems. Mothers, fathers, and adolescents (n = 301 families) provided assessments of adolescent externalizing problems, triangulation, and maternal and paternal warmth. Analyses revealed a 3-way interaction among triangulation and maternal and paternal warmth predicting adolescent externalizing problems; child gender also moderated these relations. Among highly triangulated youth, boys displayed increased externalizing problems when both parents exhibited low or high warmth, whereas girls showed increased behavior problems in the context of low maternal but high paternal warmth. These findings indicate the importance of examining the broader family context and gender when considering the impact of triangulation during adolescence.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Do Marital Conflict Behaviors in Response to a Novel Stressor Uniquely Predict Adolescent Outcomes?

The goal of this study was to examine whether mothers’ and fathers’ marital conflict behaviors in response to a novel stressor are uniquely predictive of adolescent outcomes. Previous research establishing the detrimental consequences of marital conflict for child outcomes has relied exclusively on assessments of conflict that measure reoccurring or past conflict. From 153 adolescents and/or both of their parents, reports were gathered on marital conflict, adolescent conflict appraisals, parent-adolescent relationship quality, and adolescent adjustment. Couples engaged in two marital problem-solving interaction tasks—one that elicited conflict behaviors by requiring discussion of salient, reoccurring topics of disagreement and one that prompted conflict behaviors by requiring that couples worked together to solve an unfamiliar problem. Results indicated that compared to behaviors during the marital conflict discussion as well as parent-reports of the frequency, intensity, and resolution of typical conflict, conflict behaviors in response to a novel stressor, particularly those displayed by mothers, were uniquely associated with adolescents’ conflict appraisals and dimensions of the parent-adolescent relationship but not adolescent adjustment. Specifically more-negative (relative to positive) conflict behaviors in response to the novel stressor was associated with more-negative adolescent conflict appraisals; mothers’ more-negative conflict behaviors in response to a novel stressor were also linked to adolescents reporting less parental monitoring. In contrast, parent reports of typical marital conflict uniquely predicted conflict property appraisals, the affective quality of mother-adolescent relationships, and adolescent adjustment. Implications for future research elucidating associations between conflict behaviors in response to a novel stressor on children and families are discussed.     

Evaluating a brief prevention program for improving marital conflict in community families.

Marital conflict is related to well-being in children and adults (E. M. Cummings & P. T. Davies, 2002). Marital conflict is likely most effectively ameliorated before it becomes clinically significant. However, families without significant problems may be unwilling to participate in couples therapies or other lengthy or intensive interventions. Responding to this gap, the authors developed a 4-session psychoeducational program about marital conflict for community families. Couples with children 4-8 years of age were randomly blocked into 1 of 3 groups: (1) a parent-only group (n = 24), (2) a parent-child group (n = 33), or (3) a self-study group (n = 33). Pre- and posttest and 6-month and 1-year assessments were conducted. This report evaluates (a) whether participation in a psychoeducational program for parents improved marital conflict, especially concerning ways of expressing disagreements, and (b) whether changes in marital conflict subsequently improved marital satisfaction, parenting, and child adjustment. Greater constructive and less destructive marital conflict was observed at all assessments for treatment groups, and these changes were linked with improvements in other family processes. The findings support the promise of brief, psychoeducational programs for improving marital conflict for community samples.     

Paternal and Maternal Influences on Family Functioning Among Hong Kong Chinese Families

The linkages between dyadic relationships in the family and family functioning were examined in 378 Chinese families on two occasions. The following dyadic relationships were investigated: (a) parent-child relationship qualities reported by adolescent children (questionnaire and interview measures of parenting style, parent-adolescent conflict, parent-adolescent communication, and parent-adolescent relationship) and by their parents (questionnaire measures of parent-child relationship quality and demand); and (b) marital quality reported by the parents via questionnaire measures. Results showed that parents' and children's views of family functioning were longitudinally related to dyadic relationships in the family. Relative to mother-adolescent relationship and mothers' report of marital quality, father-adolescent relationship and fathers' report of marital quality were generally found to have a stronger association with perception of family functioning and its change over time.     

Paternal and maternal influences on family functioning among Hong Kong Chinese families

The linkages between dyadic relationships in the family and family functioning were examined in 378 Chinese families on two occasions. The following dyadic relationships were investigated: (a) parent-child relationship qualities reported by adolescent children (questionnaire and interview measures of parenting style, parent-adolescent conflict, parent-adolescent communication, and parent-adolescent relationship) and by their parents (questionnaire measures of parent-child relationship quality and demand); and (b) marital quality reported by the parents via questionnaire measures. Results showed that parents' and children's views of family functioning were longitudinally related to dyadic relationships in the family. Relative to mother-adolescent relationship and mothers' report of marital quality, father-adolescent relationship and fathers' report of marital quality were generally found to have a stronger association with perception of family functioning and its change over time.     

Coparenting Conflict and Academic Readiness in Children of Teen Mothers: Effortful Control as a Mediator

Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican‐origin adolescent mothers' coparenting conflict with their 3‐year‐old children's grandmothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness. Findings revealed that adolescent mothers' coparenting conflict with their child's biological father was linked to indices of children's academic and social school readiness through children's effortful control among girls, but not boys, whereas conflict with grandmothers was directly linked to boys' and girls' social functioning 2 years later. Findings offer information about different mechanisms by which multiple coparenting units in families of adolescent mothers are related to their children's outcomes, and this work has important implications for practitioners working with families of adolescent mothers.