title: Parenting Stress Among Caregivers of Children With Bipolar Spectrum Disorders.
abstract: Caregivers of psychiatrically impaired children experience considerable parenting stress. However, no research has evaluated parenting stress within the context of pediatric bipolar spectrum disorders (BPSD). Thus, the aim of this investigation was to identify predictors and moderators of stress among caregivers in the Longitudinal Assessment of Manic Symptoms study. Participants included 640 children and their caregivers in the Longitudinal Assessment of Manic Symptoms cohort. Children had a mean age of 9.4 ± 1.9 years (68% male, 23% BPSD); parents had a mean age of 36.5 ± 8.3 years (84% mothers). Children with BPSD had more service utilization, psychiatric diagnoses, mood and anxiety symptoms, and functional impairment but fewer disruptive behavior disorders. Caregivers of children with BPSD were more likely than caregivers of children without BPSD to have a partner, elevated depressive symptoms, antisocial tendencies, and parenting stress (Cohen's d = .49). For the whole sample, higher child IQ, mania, anxiety, disruptive behavior, and caregiver depression predicted increased parenting stress; maternal conduct disorder predicted lower stress. Child anxiety and disruptive behavior were associated with elevated caregiver stress only for non-BPSD children. Caregivers of children with BPSD experience significant burden and thus require specialized, family-focused interventions. As stress was also elevated, to a lesser degree, among depressed caregivers of children with higher IQ, mania, anxiety, and disruptive behavior, these families may need additional supports as well. Although parents with conduct/antisocial problems evidenced lower stress, these difficulties should be monitored. Thus, parenting stress should be evaluated and addressed in the treatment of childhood mental health problems, especially BPSD.
authors.affiliation: a Spectrum Centre for Mental Health Research/Division of Health Research , Lancaster University.
authors.forename: Guillermo
authors.identifier: 0000-0001-6610-4951
authors.initials: G
authors.lastname: Perez Algorta
authors.affiliation: b Department of Psychology , Harvard University.
authors.forename: Heather A
authors.initials: HA
authors.lastname: MacPherson
authors.affiliation: c Department of Psychology , University of North Carolina at Chapel Hill.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.affiliation: d Department of Social Work , The Ohio State University.
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Belt
authors.affiliation: e Department of Psychiatry and Behavioral Health , The Ohio State University Wexner Medical Center.
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.affiliation: f Center for Autism , Cleveland Clinic.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.affiliation: g Department of Pediatrics , Case Western Reserve University and Rainbow Babies & Children's Hospital.
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.affiliation: h Department of Psychiatry , University of Pittsburgh Medical Center.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: i Department of Child and Adolescent Psychiatry , New York University School of Medicine.
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
authors.affiliation: j Department of Psychiatry , Johns Hopkins University/Kennedy Krieger Institute.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
authors.affiliation: e Department of Psychiatry and Behavioral Health , The Ohio State University Wexner Medical Center.|k The LAMS Team.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires