Psychosocial adjustment in children of schizophrenic mothers

When I compliacted understood loss and grief

WHAT IS KNOWN ABOUT THE SUBJECT

A parent's mental illness was viewed as a loss, like a death, causing profound grief. I learned how important parent-child communication is as an important factor in managing my own grief.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

A child's grief, in this case, from loss of a parent due to mental illness, as in death, was profound at the time and did affect many aspects of my life. The failure to intervene in a timely fashion impaired effective resolution of that grief.

IMPLICATIONS FOR MENTAL HEALTH NURSING

Assessment of family dynamics and communication is critical to building coping skills for any young child dealing with loss of parental support due to mental illness. Early intervention with young children in need of emotional support and security is needed to assist them with effective adaptation to grief and loss.

ABSTRACT

It is expected that loss of a parent from death will undoubtedly cause children to grieve. With supportive interventions, children can recover and grow into healthy, well-adjusted adults. Severe mental illness in a parent, however, also creates loss by altering the parent-child relationship, often leaving children confused, frightened and feeling alone. In the past, family members, especially the remaining parent, might not have recognized the symptoms of a grieving child and the system at that time was not well prepared to assist them in meeting that need. This is the story of one such child.

Interpersonal behavior of children at risk for schizophrenia

Investigations of the childhood antecedents of adult schizophrenia may clarify our understanding of the etiology of the disease, provide guidelines for meaningful classification of subtypes of schizophrenic illness, point to strategies for identifying those individuals in need for early intervention, and suggest appropriate techniques for early intervention. Among the more salient characteristics of schizophrenic illness are disturbances in interpersonal relations, especially withdrawal from normal social interaction.

Children of mentally ill mothers: social situation and psychometric testing of mental development

Children of mothers who satisfied the Research Diagnostic Criteria of (1) Schizophrenia, (2) Alcoholism or Drug Use Disorder, (3) Major Depressive Disorder including Mania, (4) Unspecified Functional Psychosis, and (5) Other Psychiatric Disorder and children of obstetric controls were studied with regard to subsequent mental and behavioural development and social conditions. 72 index children and 17 children from the comparison group were examined at an approximate age of six years by a child psychologist. More index children than those from the comparison group showed impaired mental and behavioural development. The children of abusing mothers in particular tended to have a worse outcome. One-half of the index children were not living with their mothers at the time of follow-up.

Crime and the schizophrenia spectrum: a diathesis-stress model

Previous studies support a relationship between schizophrenia and antisocial behavior. In the present study, offspring of schizophrenics showed a greater degree of antisocial behavior than did offspring of parents without psychopathology. The present study clarifies the interplay between risk for schizophrenia and developmental factors in determining antisocial behavior. Those variables which distinguished high-risk criminal behavior from high-risk non-criminal behavior were irritability and shortened attention span in infancy, paternal absence during ages 15 to 17, lower WAIS Verbal IQ, impoverished neighborhood, family discord and negative attitude towards father. In a multiple regression analysis, paternal absence in adolescence, shortness of attention span, and low Verbal IQ each contributed a unique portion of the variance in antisocial behavior. A block of interaction terms (Stressor X Risk) did not contribute a significant portion of the variance in antisocial behavior, suggesting that those factors which predict antisocial behavior in the high-risk group are the same factors which predict antisocial behavior in the low-risk group. In addition, a significant portion of the variance in phenotypic outcome (criminal vs. schizophrenic) was accounted for by passivity in infancy (predictive of schizophrenia) and low Verbal IQ (more common in high-risk criminals). Shortened attention spans in infancy were found to precede both criminal behavior and schizophrenia in this sample. This feature may therefore indicate a genetic vulnerability to schizophrenia.

Motor impairment and antisocial behavior in adolescent males at high risk for schizophrenia

A familial link between schizophrenia and antisocial behavior has been established (e.g., Silverton, 1985). This study examined this relationship in a Danish cohort. The subjects were 36 high-risk males (offspring of a schizophrenic parent) and 36 low-risk males (offspring of parents without psychopathology). This high-risk subjects exhibited more antisocial behavior than the low-risk subjects. We tested the hypothesis of a correlation between neurointegrative deficits, as defined by motor impairment, and antisocial behavior, rated at ages 10-13, in subjects at genetic risk for schizophrenia. Path analyses were conducted from motor impairment at 1 year and motor impairment at 10-13 years to antisocial behavior separately for high-risk and low-risk subjects. Adolescent motor impairment was a significant predictor of antisocial behavior for high-risk subjects. Motor impairment at 1 year was also associated with antisocial behavior for these subjects, although the association was partly due to the indirect effects of motor impairment at 1 year on motor impairment at 10-13 years, which, in turn, was associated with changes in antisocial behavior. As predicted, none of the path coefficients nor the effect coefficient was significant for low-risk subjects.

Children of disturbed parents: the interface between research and intervention

This paper provides a review of high-risk studies and preventive interventions with children who have an increased likelihood of developing psychopathology because they are the offspring of emotionally disturbed parents. The research implications for preventive interventions are summarized in terms of selection of participants, goals for prevention, intervention methods, and intervention research methodology. Next, several preventive intervention programs are reviewed and evaluated for their responsiveness to the research literature. The review revealed that, despite theoretical and methodological diversity in the research literature, the findings provide many suggestions for the design of preventive interventions. On the other hand, intervention programs were most often found to have not used research findings in program design. This review concludes with suggestions for needed research and guidelines for future preventive interventions.

Health of children whose parents seek psychiatric care

The study comprises 69 pre-school children whose parents, mainly mothers, had sought care at a department of psychiatry in Stockholm. The majority of the parents had attended for recurrent ambulatory treatment (58%) or had only come to the emergency room (25%). The children demonstrated a significantly higher frequency of somatic and emotional symptoms than a matched control group. To a large extent, the index children showed failure to thrive without any apparent organic cause. In exceptional cases there had been co-operation between the departments of psychiatry and paediatrics (one case) as well as between the departments of psychiatry and social welfare (five cases). There is an urgent need to develop methods within the scope of psychiatric care whereby the best interests of both the parents and the children are taken into consideration.

Effects of marital discord on the school behavior of children of schizophrenic, affectively disordered, and normal parents

An association between children's school behavior and two family variables, marital discord and parental psychopathology, has been consistently reported in the literature. However, the joint effects of each of these two familial factors has not been closely examined. The present report provides a further examination of the interrelationships among these three variables with particular emphasis on the effects of marital discord on children's school behavior in families with behaviorally disturbed parents. Marital discord was found to account for much of the association between having a parent with bipolar disorder or unipolar depression and problematic school behavior, but the same variable did not explain the relationship between having a schizophrenic parent and problems in school. The implications of these findings for interventions with the children of disturbed parents and for high-risk research are discussed.

On being the offspring of an alcoholic: an update

Reporting on research advances in a previous review of the literature, this article discusses the relative lack of controlled and prospective studies, the need for more treatment resources, the vulnerability of children of alcoholic parents compared to those of parents with other psychiatric diagnoses, and speculates on the sources of strength of the competent child of alcoholic parents.

Peer evaluations of the competence of children vulnerable to psychopathology

Peer evaluations of the behavior of 75 children of schizophrenic mothers, 57 children of depressed mothers, and 153 controls were collected using the Pupil Evaluation Inventory. The children, both boys and girls, were in grades 2 through 9. Both male and female children of schizophrenics were viewed more deviantly than controls on Aggression and Unhappiness-Withdrawal factors. Only the female children of schizophrenics were viewed as less likable than controls. In general, children of schizophrenics did not differ from children of depressives. The exception was the older daughters of schizophrenics, who were rated as more deviant than members of both the remaining groups.

Psychosocial adjustment of the offspring of psychiatric inpatients: the effect of alcoholic, depressive and schizophrenic parentage

While there is a growing body of literature describing the plight of being the child of a particular diagnostic group of psychiatrically ill parents, little is yet known about the comparable vulnerability of the children of various diagnostic groups.

This study includes data collected on 90 psychiatric inpatients, their spouses and children. For each consecutive admission of fifteen male and fifteen female alcoholics with a child less than age 21, a schizophrenic and a depressive parent were matched by sex, age and time of admission. Data were collected on the parents and their children from the patient's chart and through a structured interview with the spouse. A medical history, Rutter's parental questionnaire on children's behaviour and the Randall-McClure behaviour checklist were filled out on 231 children.

Some of the findings of the study include that the adjustment of the children based on checklist information is not affected by the psychiatric diagnosis of the parents; controlling for sibship size is important in this type of research; the boys of sick fathers score almost two times higher on the checklists compared to the boys of sick mothers. The results argue for the provision of coordinated services between adult and child psychiatry departments for the children of the psychiatrically ill parents.

Children of depressed and schizophrenic mothers

A sample of psychotic mothers and their children who were five years or younger when first recruited for our study of high risk children was followed up five years later. The current sample, obtained from our previous work, consisted of 18 schizophrenic, 12 depressed and psychotic, and 22 well mothers and their six to 12 year old children. The mothers were equated for education and age, and the children for sex and age. Cognitive style tests and interviews measuring social adjustment and functioning were given to both the parents and the children.