title: Adaptation to bipolar disorder and perceived risk to children: a survey of parents with bipolar disorder.
abstract: BACKGROUND
  Bipolar disorder (BPD) is a common condition associated with significant morbidity and reduced quality of life. In addition to challenges caused by their mood symptoms, parents affected with BPD harbor concerns about the mental health of their children. Among adult parents who perceive themselves to have BPD, this study aims to examine participants' coping methods; identify predictors of adaptation; assess parental perceptions of risks for mood disorders among their children; and describe the relationships among illness appraisals, coping, adaptation to one's own illness, and perceived risk to one's children.
  
  
  METHODS
  Parents who self-identified as having BPD completed a web-based survey that assessed dispositional optimism, coping, perceived illness severity, perceived etiology of BPD, perceived risk to offspring, and adaptation to BPD. Participants had at least one unaffected child who was 30 years of age or below.
  
  
  RESULTS
  266 parents were included in the analysis. 87% of parents endorsed a "somewhat greater" or "much greater" risk for mood disorders in one's child(ren) than someone without a family history. Endorsing a genetic/familial etiology to BPD was positively correlated with perceived risk for mood disorders in children (rs = .3, p < 0.01) and active coping with BDP (r = .2, p < 0.01). Increased active coping (β = 0.4, p < 0.001) and dispositional optimism (β = 0.3, p < 0.001) were positively associated with better adaptation, while using denial coping was negatively associated with adaptation (β = -0.3, p < 0.001). The variables explained 55.2% of the variance in adaptation (F = 73.2, p < 0.001). Coping mediated the effect of perceived illness severity on adaptation.
  
  
  CONCLUSIONS
  These data inform studies of interventions that extend beyond symptom management and aim to improve the psychological wellbeing of parents with BPD. Interventions targeted at illness perceptions and those aimed at enhancing coping should be studied for positive effects on adaptation. Parents with BPD may benefit from genetic counseling to promote active coping with their condition, and manage worry about perceived risk to their children.
authors.affiliation: Social and Behavioral Research Branch, National Human Genome Research Institute NHGRI, Building 31 Room B1B36 31 Center Drive MSC 2073, Bethesda, MD 20892, USA. hpeay@mail.nih.gov.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Peay
authors.forename: Donald L
authors.initials: DL
authors.lastname: Rosenstein
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Biesecker
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents; D002675:Child, Preschool; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D010465:Perception; D012306:Risk; D018570:Risk Assessment; D011795:Surveys and Questionnaires