Abstract

The offspring of parents with bipolar disorder (OBD) are at elevated risk for mental health problems throughout the lifespan. In addition to genetic factors, environmental risk is purported to be associated with these negative outcomes. The current dissertation was designed to both examine and intervene in the relations between exposure to distinct aspects of the caregiving environment in middle childhood and psychopathology in the OBD. In the first study, concurrent and longitudinal data were used to investigate if levels of support (emotional warmth), structure (organization and consistency), and control (disciplinary strategies) provided by parents in middle childhood mediated the relation between having a parent with bipolar disorder and offspring mental health. Relative to support, structure provided by parents in the home was found to have robust effects on emotional and behavioral problems in middle childhood, while control promoted psychological adjustment in the OBD up to 12 years later. In the second study, the efficacy of a 12-week program, entitled Reducing Unwanted Stress in the Home (RUSH), was examined using a quasi-experimental design with an assessment-only control group. The program, based on empirical research in the OBD, was designed to improve the quality of the caregiving environment in childhood and to promote effective coping skills and resilience among the OBD, with the end goal of reducing their risk of adverse mental health outcomes as they develop. Assessments were conducted at four time points up to six months following the end of the RUSH program, during which parent-child interaction quality (parental positivity and negativity, and dyadic mutuality) was measured in the laboratory. Participation in the RUSH program was found to decrease rates of parent- and teacher-reported internalizing symptoms in the OBD six months later via pre-to-post intervention gains in parental negativity and positivity, respectively. Together, these studies suggest that suboptimal childrearing environments in families with a parent having BD represent a putative causal mechanism for internalizing and externalizing problems among the OBD. These data further imply that, even for highly heritable disorders like bipolar disorder, manipulations of the caregiving environment via short and targeted intervention can be of benefit.