Parental Mental Illness, Borderline Personality Disorder, and Parenting Behavior: The Moderating Role of Social Support

Perceived social support in parents with schizophrenia or bipolar disorder and their co-parents: The Danish high risk and resilience study VIA 7

BACKGROUND

Lack of social support is a risk factor for symptom recurrence and poor prognosis for individuals with severe mental disorders. Compared to healthy populations, individuals with schizophrenia or bipolar disorder are more likely to perceive lower levels of social support. Evidence is needed on perceived social support in parents with schizophrenia or bipolar disorder and their co-parents.

METHODS

Based on data from a population-based cohort study, The Danish High Risk and Resilience Study - VIA 7, we compared perceived social support measured with The Social Provisions Scale (SPS) in parents with schizophrenia (n = 148), their co-parents (n = 157), parents with bipolar disorder (n = 98), their co-parents (n = 89), and control parents (n = 359).

RESULTS

We found lower levels of perceived social support in parents with schizophrenia and bipolar disorder compared with controls. Schizophrenia co-parents had lower levels of perceived social support compared to controls, but no difference was found between bipolar disorder co-parents and controls.

CONCLUSIONS

Low levels of perceived social support for these parents may pose an additional risk factor for their offspring in addition to the effects of genetic risk. Our results may inform future intervention studies and highlight the need for support for families with parental schizophrenia or bipolar disorder.

Low perceived social support in mothers during pregnancy and early childhood; associations with anxiety and ADHD symptoms in children at 3 and 8 years

PURPOSE

Low perceived social support is associated with adverse effects on maternal mental health, and often coexists with other risk factors for offspring anxiety and attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether low maternal social support during pregnancy and early childhood predicted anxiety and ADHD symptoms in children at ages 3.5 and 8 years.

METHODS

This study is part of the longitudinal, population-based Norwegian Mother, Father, and Child Cohort Study. Mothers were queried about perceived social support twice during pregnancy, and again at child ages 18 months and 3 years. They were interviewed about their children's symptoms of anxiety and ADHD at 3.5 years. At 8 years (n = 781), the Child Symptom Inventory-4 was used to identify children who fulfilled the criteria for anxiety disorders and ADHD. Logistic regression models estimated the risk of child anxiety and ADHD, depending on maternal social support.

RESULTS

Low maternal social support predicted child anxiety symptoms at both ages 3.5 and 8 years as well as ADHD symptoms at 8 years. When including other maternal stressors and child risk factors, low maternal social support remained a significant predictor for child anxiety symptoms at 3.5 years, and there was a trend towards also predicting child anxiety and ADHD symptoms at 8 years.

CONCLUSION

The associations between low maternal social support and child symptoms of anxiety and ADHD found in the present study, suggest that focusing on mothers with low social support may hold significance for child symptoms years later.

The effect of mental health problems on having a 'neither in employment nor in education or training' period and the mediating role of high school dropout: a register-based study with a 14-year follow-up

INTRODUCTION

This study investigates (1) whether mental health problems among individuals aged 12-15 years impact (a) high school dropout (ages 16-20 years) and (b) having a 'neither in employment nor in education or training' (NEET) period (ages 21-26 years); (2) the process of mediation and interaction by high school dropout in the association between mental health problems and NEET; and (3) whether these associations differ based on (non-)employment and mental health problems of parents.

METHODS

Longitudinal register data were used (n=196 227). Log-linear regression analyses were used to assess the association between reimbursed medication for mental health problems and high school dropout or NEET period for at least 12 months. Causal mediation analysis was used to assess the mediation and interaction effects of high school dropout in the association between mental health problems and NEET. Stratified analyses were performed based on parental employment and mental health status.

RESULTS

Mental health problems were strongly associated with high school dropout (RR 1.96, 95% CI 1.88; 2.04) and NEET (RR 2.44, 95% CI 2.35; 2.52). High school dropout had a small mediating effect in the relationship between mental health problems and NEET. Individuals with parents with mental health problems or non-employment more often experienced high school dropout and being NEET, but the mediating effect of dropout on NEET was lower in these individuals.

CONCLUSION

Preventing mental health problems early in the lifecourse is of paramount importance to promote educational outcomes and employment participation, but high school dropout only plays a marginal role in this relationship.

Emotion Regulation, Parenting, and Psychopathology: A Systematic Review

The presence of a parental mental disorder can lead to adverse outcomes for children. Difficulties in emotion regulation are observed across a range of mental health problems and may play a crucial role in this context. Following PRISMA guidelines, we systematically searched Medline, PsycINFO, Embase, and Web of Science for studies examining the association between emotion regulation in parents with psychopathology at a clinical or subclinical level and their parenting. The protocol was registered with the PROSPERO international prospective register of systematic reviews (CRD42021224954; January 2021). A total of 23 studies were included in the qualitative synthesis. Emotion regulation was predominantly assessed using self-report on the general ability (e.g., Difficulties in Emotion Regulation Scale). The assessment of parenting encompassed a broad range of aspects and operationalizations. Across psychopathology in parents, several aspects of difficulties in emotion regulation were associated with unfavorable emotion socialization, more negative parenting, and partially with less positive parenting. Slightly different effects were observed for posttraumatic stress disorder and anxiety disorders. For parents with depressive disorders, specific emotion regulation strategies (suppression, reappraisal) seem to buffer against negative parenting. Since the majority of studies refer only to mothers, generalization to fathers is limited. Furthermore, conclusions are limited due to study heterogeneity and lack of prospective studies. Nevertheless, findings suggest that interventions should target the improvement of emotion regulation in parents with psychopathology.

Parenting stress in parents with and without a mental illness and its relationship to psychopathology in children: a multimodal examination

Objective

Children of parents with a mental illness are at heightened risk to develop a mental illness themselves due to genetics and environmental factors. Although parenting stress (PS) is known to be associated with increased psychopathology in parents and children, there is no study investigating PS multimodally in a sample of parents with a mental illness. This study aims to compare PS of parents with and without a mental illness and further to examine the relationship between PS and psychopathology of children.

Methods

Participants were parents with a mental illness and parents without a mental illness and their children aged four to sixteen years. We assessed PS multimodally using a questionnaire, parents' evaluation of children's behavior (relational schemas) and psychophysiological arousal of parents during free speech task.

Results

Self-reported PS was increased, and evaluation of children's behavior was more negative and less positive in parents with a mental illness compared to parents without a mental illness. Children's psychopathology was associated with self-reported PS and relational schemas of parents. Regarding psychophysiological arousal, parents with a mental illness showed reduced reactivity in heart rate from baseline to free speech task in comparison to parents without a mental illness.

Conclusions

Our findings highlight the importance of implementing intervention programs to reduce PS for parents and children. In particular, parents with a mental illness might benefit from specific intervention programs in order to interrupt the transgenerational transmission of mental disorders.

Integrating Psychosocial Risks With Emerging Evidence for Borderline Personality Disorders in Adolescence: An Update for Clinicians

Borderline personality disorder (BPD) has seen significant advances in the knowledge of its developmental phenomenology during late childhood and adolescence. Various genetic, neurobiological, psychological, and social factors are implicated in the etiology of BPD. With emerging evidence on BPD development in adolescence, the review focused on recent literature to understand the role of psychosocial risk factors. The effects of adverse familial environment, physical, emotional, verbal, and sexual abuse, intergenerational transmission of psychopathological traits, maternal neglect and rejection, low socioeconomic status, bullying victimization, and dating violence were reviewed to understand their role in the development of BPD. BPD is a highly complex, serious, and enduring mental illness that has now been widely accepted to have symptoms that onset in early adolescence and could be diagnosed as early as age 12. BPD symptoms are stable, phenomenologically distinct from externalizing and internalizing disorders, and often present with co-occurring disorders, which during assessment could not explain impairments associated with BPD. New measures like the Difficulties in Emotion Regulation Scale (DERS), detailed developmental histories, understanding of psychosocial risks, shared decision-making, and psychoeducation could assist in early diagnosis and improvement of long-term outcomes. The implementation of evidence-based treatments is a challenge given higher costs and access to services; therefore, modifications in the treatment based on the core principles of these strategies should be considered. It is imperative to screen for psychosocial factors early in higher-risk groups. The assessment of familial factors, parental histories of psychopathologies, and histories of childhood abuse is important in context with impairing symptoms of clinical presentation and dimensional aspects of self-functioning. The role of family therapies, parental psychoeducation, and the integration of trauma-informed care approaches are important for clinical outcomes. Also, coordinated efforts with multiple stakeholders like school awareness programs, anti-bullying policies, legislation, and enforcement of existing laws might be instrumental in addressing issues related to victimization by peers.

The predictive role of impulsivity and perceived social support in psychiatric symptoms of women with methamphetamine use disorder

Background

Currently, few studies have examined the mental states of Women methamphetamine patients, and the influence of impulsivity and perceived social support on substance misuse-induced mental disorders is unclear. We want to examine the mental state of women with methamphetamine use disorder and compare it to the Chinese norm value of healthy women. Investigate the connection between impulsivity, perceived social support and mental state of women with methamphetamine use disorder.

Method

Two hundred thirty women subjects with a history of methamphetamine usage were recruited. The Chinese version of the SCL-90-R, (SCL-90) was used to evaluate psychological health problems, while the Multidimensional Scale of Perceived Social Support (MSPSS) and Barratt Impulsiveness Seale-11 (BIS-11) were utilized to evaluate perceived social support and impulsivity, respectively. The t-test, Pearson correlation analysis, multivariable linear regression, stepwise regression models, moderating effect analysis were used to analyze the statistics.

Results

There was a noticeable difference between the Chinese norm and all participants' SCL-90 ratings, especially for Somatization (t = 24.34, p < 0.001), Anxiety (t = 22.23, p < 0.001), Phobic anxiety (t = 26.47, p < 0.001), and Psychoticism (t = 24.27, p < 0.001). In addition, perceived social support levels and impulsivity levels are independently predictive of SCL-90 scores. Lastly, the impact of Impulsivity on SCL-90 can be modulated by perceived social support.

Conclusion

According to this study, women with methamphetamine use disorder have worse mental health conditions compared to healthy subjects. Furthermore, certain psychological symptoms associated with methamphetamine use in women can be aggravated by impulsivity, while perceived social support acts as a protective factor for methamphetamine-related psychiatric symptoms. Specifically, perceived social support weakens the impact of impulsivity on psychiatric symptoms in women with methamphetamine use disorder.