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A comprehensive assessment of personality traits and psychosocial functioning in parents with bipolar disorder and their intimate partners


A comprehensive assessment of personality traits and psychosocial functioning in parents with bipolar disorder and their intimate partners

Serravalle, Lisa, Iacono, Vanessa, Hodgins, Sheilagh and Ellenbogen, Mark A. (2020) A comprehensive assessment of personality traits and psychosocial functioning in parents with bipolar disorder and their intimate partners. International Journal of Bipolar Disorders, 8 (8).

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Background: Individuals with bipolar disorder (BD) often possess maladaptive traits and present with various difficulties in psychosocial functioning. However, little is known about the intimate partners of adults with bipolar disorder (BD) and how mental illnesses other than BD within couples may further complicate the picture. Such knowledge is needed to inform both couple and family interventions.
Methods: Participants were parents whose children were enrolled in a prospective study: 55 with BD and their partners, and 47 healthy control couples. All completed diagnostic interviews, and questionnaires describing personality traits, negative life events, coping skills, social support, marital adjustment and inter-partner verbal aggression. Parents with BD and healthy control parents were compared, as were the intimate partners. A series of exploratory analyses focused on the average measures within couples, with and without BD, and took account of comorbid personality disorders among those with BD and major depressive disorder among their partners.
Results: Intimate partners of adults with BD, relative to healthy control partners, presented with more mental disorders, higher neuroticism, lower extraversion, more emotion-focused coping, smaller social networks, less satisfaction with their social networks, and little, satisfying social contact. Additionally, they reported less consensus and satisfaction in their marital relationships, and engaged in more verbal aggression towards their partners. Participants with BD showed similar, more extreme, characteristics. Marital distress and verbal aggression were greatest among couples with an adult having BD and a comorbid personality disorder or a partner with major depressive disorder.
Conclusion: This study contributes to the literature by demonstrating that both parents with BD and their intimate
partners exhibit high levels of mental illness, maladaptive personality traits and psychosocial difficulties, thus limiting their partners’ ability to provide support and stability in the these high risk families. Moreover, mental illnesses other than BD may contribute to marital problems within couples. Some statistical analyses, particularly those involving comorbid conditions, were under-powered in this study. As clinical implications, the current study suggests that both individuals with BD and their partners could benefit from interventions aimed at lowering emotionality and verbal aggression, and increasing social support and effective coping skills.

Divisions:Concordia University > Faculty of Arts and Science > Psychology
Item Type:Article
Authors:Serravalle, Lisa and Iacono, Vanessa and Hodgins, Sheilagh and Ellenbogen, Mark A.
Journal or Publication:International Journal of Bipolar Disorders
  • Canadian Institutes of Health Research (CIHR)
  • Fonds de Recherches du Québec – Santé (FRQS)
  • Social Sciences and Humanities Research Council of Canada (SSHRC)
Digital Object Identifier (DOI):10.1186/s40345-019-0172-x
Keywords:Bipolar disorder, Intimate partners, Personality, Psychosocial functioning, Marital adjustment
ID Code:986497
Deposited On:17 Mar 2020 16:44
Last Modified:17 Mar 2020 16:44


Barrera M. A method for the assessment of social support networks in community survey research. Connections. 1980;3:8–13.

Barrera M, Sandler IN, Ramsay TB. Preliminary development of a scale of social support: studies on college students. Am J Community Psychol. 1981;9:435–47. https://doi.org/10.1007/BF00918174.

Bella T, Goldstein T, Axelson D, Obreja M, Monk K, Hickey MB, Goldstein B, Brent D, Diler RS, Kupfer D, Sakolsky D. Psychosocial functioning in of spring of parents with bipolar disorder. J Affect Disord. 2011;133:204–11. https:// doi.org/10.1016/j.jad.2011.03.022.

Bender RE, Alloy LB, Sylvia LG, Uroševic S, Abramson LY. Generation of life events in bipolar spectrum disorders: a re-examination and extension of the stress generation theory. J Clin Psychol. 2010;66:907–26. https://doi. org/10.1002/jclp.20705.

Beyer JL, Kuchibhatla M, Looney C, Engstrom E, Cassidy F, Krishnan KRR. Social support in elderly patients with bipolar disorder. Bipolar Disord. 2003;5:22–7.

Bienvenu OJ, Hettema JM, Neale MC, Prescott CA, Kendler KS. Low extraversion and high neuroticism as indices of genetic and environmental risk for social phobia, agoraphobia, and animal phobia. Am J Psychiatry. 2007;164:1714–21. https://doi.org/10.1176/appi.ajp.2007.06101667.

Borowiecka-Karpiuk J, Dudek D, Siwek M, Jaeschke R. Spousal burden in partners of patients with major depressive disorder and bipolar disorder. Psychiatr Pol. 2014;48:773–87.

Bouchard G, Sabourin S, Lussier Y, Wright J, Boucher C. La structure factorielle de la version français de l’Échelle d’adjustemente dyadique. Can J Counselling Psychother/Revue canadienne de counseling et de psychothér. 1991;25:4–11.

Brands IM, Köhler S, Stapert SZ, Wade DT, van Heugten CM. Psychometric properties of the Coping Inventory for Stressful Situations (CISS) in patients with acquired brain injury. Psychol Assess. 2014;26:848. https:// doi.org/10.1037/a0036275.

Brieger P, Ehrt U, Marneros A. Frequency of comorbid personality disorders in bipolar and unipolar affective disorders. Compr Psychiatry. 2003;44:28–34. https://doi.org/10.1053/comp.2003.50009.

Butterworth P, Rodgers B. Mental health problems and marital disruption: is it the combination of husbands and wives’ mental health problems that predicts later divorce? Soc Psychiatry Psychiatr Epidemiol. 2008;43:758– 63.

Carpenter D, Clarkin JF, Glick ID, Wilner PJ. Personality pathology among married adults with bipolar disorder. J Affect Disord. 1995;34:269–74. https:// doi.org/10.1016/0165-0327(95)00024-H.

Costa PT, McCrae RR. Normal personality assessment in clinical practice: The NEO Personality Inventory. Psychol Assess. 1992;4:5. https://doi. org/10.1037/1040-3590.4.1.5.

Costa PT Jr, Herbst JH, McCrae RR, Siegler IC. Personality at midlife: stability, intrinsic maturation, and response to life events. Assessment. 2000;7:365– 78. https://doi.org/10.1177/107319110000700405.

Dohrenwend BS, Askenasy AR, Krasnof L, Dohrenwend BP. Exemplification of a method for scaling life events: the PERI Life Events Scale. J Health Soc Behav. 1978. https://doi.org/10.2307/2136536.

Dufy A, Alda M, Crawford L, Milin R, Grof P. The early manifestations of bipolar disorder: a longitudinal prospective study of the offspring of bipolar parents. Bipolar Disord. 2007;9:828–38.
https://doi.org/10.111 1/j.1399-5618.2007.00421.x.

Dufy A, Horrocks J, Doucette S, Keown-Stoneman C, McCloskey S, Grof P. The developmental trajectory of bipolar disorder. Br J Psychiatry. 2014;204:122–8. https://doi.org/10.1192/bjp.bp.113.126706.

Eidelman P, Gershon A, Kaplan K, McGlinchey E, Harvey AG. Social support and social strain in inter-episode bipolar disorder. Bipolar Disord. 2012;14:628– 40.

Eley TC, Plomin R. Genetic analyses of emotionality. Curr Opin Neurobiol. 1997;7:279–84.

Ellenbogen MA, Hodgins S. The impact of high neuroticism in parents on children’s psychosocial functioning in a population at high risk for major affective disorder: A family environmental pathway of intergenerational risk. Dev Psychopathol. 2004;16:113–36. https://doi.org/10.1017/S0954 579404044438.

Ellenbogen MA, Ostiguy CS, Hodgins S. Intergenerational effects of high neuroticism in parents and their public health significance. Am Psychol. 2010. https://doi.org/10.1037/a0018512.

Endler NS, Parker JD. Assessment of multidimensional coping: Task, emotion, and avoidance strategies. Psychol Assess. 1994;6:50. https://doi. org/10.1037/1040-3590.6.1.50.

Fan AH, Hassell J. Bipolar disorder and comorbid personality psychopathology: a review of the literature. J Clin Psychiatry. 2008;69:1794–803. https://doi. org/10.4088/JCP.v69n1115.

Fletcher K, Parker GB, Manicavasagar V. Coping profiles in bipolar disorder. Compr Psychiatry. 2013;54:1177–84. https://doi.org/10.1016/j.compp sych.2013.05.011.

George EL, Miklowitz DJ, Richards JA, Simoneau TL, Taylor DO. The comorbidity of bipolar disorder and axis II personality disorders: prevalence and clinical correlates. Bipolar Disord. 2003;5:115–22. https://doi.org/10.103 4/j.1399-5618.2003.00028.x.

Gibbon M, Spitzer RL, Williams JB, Benjamin LS, First MB. Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). Am Psych Pub. 1997. https://doi.org/10.1521/pedi.1997.11.3.279.

Gibbons P, Collins M, Reid C. How useful are indices of personality pathology when assessing domestic violence perpetrators? Psychol Assess. 2011;23:164. https://doi.org/10.1037/a0021289.

Hakulinen C, Elovainio M, Pulkki-Råback L, Virtanen M, Kivimäki M, Jokela M. Personality and depressive symptoms: individual participant meta-analysis of 10 cohort studies. Depress Anxiety. 2015;32:461–70. https:// doi.org/10.1002/da.22376.

Hodgins S, Faucher B, Zarac A, Ellenbogen MA. Children of parents with bipolar disorder: a population at high risk for major affective disorders. Child Adolesc Psychiatr Clin N Am. 2002;11:533–53. https://doi.org/10.1016/ S1056-4993(02)00002-0.

Iacono V, Beaulieu L, Hodgins S, Ellenbogen MA. Parenting practices in middle childhood mediate the relation between growing up with a parent having bipolar disorder and offspring psychopathology from childhood into early adulthood. Dev Psychopathol. 2018;30:635–49. https://doi. org/10.1017/S095457941700116X.

Jacobs N, Van Os J, Derom C, Thiery E, Delespaul P, Wichers M. Neuroticism explained? From a non-informative vulnerability marker to informative person–context interactions in the realm of daily life. Br J Clin Psychol. 2011;50:19–32. https://doi.org/10.1348/014466510X491397.

Kendler KS, Kessler RC, Walters EE, MacLean C, Neale MC, Heath AC, Eaves LJ. Stressful life events, genetic liability, and onset of an episode of major depression in women. Focus. 2010;8:459–70. https://doi.org/10.1176/foc.8.3.foc459.

Kieseppä T, Partonen T, Haukka J, Kaprio J, Lönnqvist J. High concordance of bipolar I disorder in a nationwide sample of twins. Am J Psychiatry. 2004;161:1814–21. https://doi.org/10.1176/ajp.161.10.1814.

Kline RB. Becoming a behavioral science researcher: a guide to producing research that matters. New York: Guilford Press; 2008.

Kogan JN, Otto MW, Bauer MS, Dennehy EB, Miklowitz DJ, Zhang HW, Ketter T, Rudorfer MV, Wisniewski SR, Thase ME, Calabrese J. Demographic and diagnostic characteristics of the first 1000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Bipolar Disord. 2004;6:460–9. https://doi.org/10.111 1/j.1399-5618.2004.00158.x.

Lam D, Donaldson C, Brown Y, Malliaris Y. Burden and marital and sexual satisfaction in the partners of bipolar patients. Bipolar Disord. 2005;7:431–40. https://doi.org/10.1111/j.1399-5618.2005.00240.x.

Loftus ST, Jaeger J. Psychosocial outcome in bipolar I patients with a personality disorder. J Nerv Ment Dis. 2006;194:967–70. https://doi.org/10.1097/01.nmd.0000243814.35854.10.

MacQueen GM, Young LT, Jofe RT. A review of psychosocial outcome in patients with bipolar disorder. Acta Psychiatr Scand. 2001;103:163–70.
https://doi.org /10.1034/j.1600-0447.2001.00059.x.

Mathews CA, Reus VI. Assortative mating in the affective disorders: a systematic review and meta-analysis. Compr Psychiatry. 2001;42:257–62. https://doi. org/10.1053/comp.2001.24575.

McElroy SL, Altshuler LL, Suppes T, Keck PE Jr, Frye MA, Denicof KD, Nolen WA, Kupka RW, Leverich GS, Rochussen JR, Rush AJ. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with Serravalle et al. Int J Bipolar Disord (2020) 8:8 Page 13 of 13 bipolar disorder. Am J Psychiatry. 2001;158:420–6. https://doi.org/10.1176/ appi.ajp.158.3.420.

Merikangas KR, Weissman MM, Prusof BA, John K. Assortative mating and affective disorders: psychopathology in offspring. Psychiatry. 1988;51(1):48–57. https://doi.org/10.1080/00332747.1988.11024379.

Miklowitz DJ. A review of evidence-based psychosocial interventions for bipolar disorder. J Clin Psychiatry. 2006;67:28–33.

Miklowitz DJ, George EL, Richards JA, Simoneau TL, Suddath RL. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry. 2003;60:904–12. https://doi.org/10.1001/archpsyc.60.9.904.

Miklowitz DJ, Schneck CD, Walshaw PD, Garrett AS, Singh MK, Sugar CA, Chang KD. Early intervention for youth at high risk for bipolar disorder: a multisite randomized trial of family-focused treatment. Early Intervent Psychiatry. 2017. https://doi.org/10.1111/eip.12463.

Moon E, Chang JS, Choi S, Ha TH, Cha B, Cho HS, Park JM, Lee BD, Lee YM, Choi Y, Ha K. Characteristics of stress-coping behaviors in patients with bipolar disorders. Psychiatry Res. 2014;218:69–74. https://doi.org/10.1016/j.psych res.2014.03.047.

Nijjar R, Ellenbogen MA, Hodgins S. Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: a comprehensive psychosocial assessment. J Affect Disord. 2014;166:315–23. https://doi. org/10.1016/j.jad.2014.04.047.

Nijjar R, Ellenbogen MA, Hodgins S. Sexual risk behaviors in the adolescent offspring of parents with bipolar disorder: prospective associations with parents’ personality and externalizing behavior in childhood. J Abnorm Child Psychol. 2016;44:1347–59. https://doi.org/10.1007/s10802-015-0112-x.

Nordsletten AE, Larsson H, Crowley JJ, Almqvist C, Lichtenstein P, Mataix-Cols D. Patterns of nonrandom mating within and across 11 major psychiatric disorders. JAMA Psychiatry. 2016;73:354–61. https://doi.org/10.1001/jamap sychiatry.2015.3192.

Ostiguy CS, Ellenbogen MA, Linnen AM, Walker EF, Hammen C, Hodgins S. Chronic stress and stressful life events in the offspring of parents with bipolar disorder. J Affect Disord. 2009;114:74–84. https://doi.org/10.1016/j. jad.2008.08.006.

Ostiguy CS, Ellenbogen MA, Walker CD, Walker EF, Hodgins S. Sensitivity to stress among the offspring of parents with bipolar disorder: a study of daytime cortisol levels. Psychol Med. 2011;41:2447–57. https://doi.org/10.1017/ S0033291711000523.

Ostiguy CS, Ellenbogen MA, Hodgins S. Personality of parents with bipolar disorder and interpersonal functioning among their ofspring: A prospective 10-year study. Dev Psychopathol. 2012;24:573–87. https://doi.org/10.1017/ S095457941200017X.

Perlick DA, Rosenheck RA, Miklowitz DJ, Chessick C, Wolf N, Kaczynski R, Ostacher M, Patel J, Desai R. Prevalence and correlates of burden among caregivers of patients with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. Bipolar Disord. 2007;9:262–73. https://doi.org/10.1111/j.1399-5618.2007.00365.x.

Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord. 2016;18:183–91. https://doi.org/10.1111/bdi.12379.

Rea MM, Tompson MC, Miklowitz DJ, Goldstein MJ, Hwang S, Mintz J. Familyfocused treatment versus individual treatment for bipolar disorder: results of a randomized clinical trial. J Consult Clin Psychol. 2003;71:482. https://doi. org/10.1037/0022-006X.71.3.482.

Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M, Goikolea JM, Benabarre A, Daban C, Sánchez-Moreno J. What really matters to bipolar patients’ caregivers: sources of family burden. J Affect Disord. 2006;94:157– 63. https://doi.org/10.1016/j.jad.2006.04.022.

Rende R, Hodgins S, Palmour R, Faucher B, Allaire JF. Familial overlap between bipolar disorder and psychotic symptoms in a Canadian cohort. Can J Psychiatry. 2005;50:189–94. https://doi.org/10.1177/070674370505000401.

Risch N, Herrell R, Lehner T, Liang KY, Eaves L, Hoh J, Griem A, Kovacs M, Ott J, Merikangas KR. Interaction between the seonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: a meta-analysis. JAMA. 2009;301:2462–71. https://doi.org/10.1001/jama.2009.878.

Rolland JP, Parker WD, Stumpf H. A psychometric examination of the French translations of NEO-PI-R and NEO-FFI. J Pers Assess. 1998;71:269–91. https:// doi.org/10.1207/s15327752jpa7102_13.

Shaw JA, Egeland JA, Endicott J, Allen CR, Hostetter AM. A 10-year prospective study of prodromal patterns for bipolar disorder among Amish youth. J Am Acad Child Adolesc Psychiatry. 2005;44:1104–11. https://doi.org/10.1097/01. chi.0000177052.26476.e5.

Song J, Bergen SE, Kuja-Halkola R, Larsson H, Landén M, Lichtenstein P. Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population. Bipolar Disord. 2015;17:184–93. https://doi. org/10.1111/bdi.12242.

South SC, Turkheimer E, Oltmanns TF. Personality disorder symptoms and marital functioning. J Consult Clin Psychol. 2008;76:769. https://doi.org/10.1037/ a0013346.

Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marital Fam. 1976. https://doi. org/10.2307/350547.

Spanier GB, Thompson L. A confirmatory analysis of the dyadic adjustment scale. J Marital Fam. 1982. https://doi.org/10.2307/351593.

Spitzer RL, Williams JB, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID): I: history, rationale, and description. Arch Gen Psychiatry. 1992;49:624–9. https://doi.org/10.1001/archpsyc.1992.01820080032005.

Stice E, Ragan J, Randall P. Prospective relations between social support and depression: differential direction of effects for parent and peer support? J Abnorm Psychol. 2004;113:155. https://doi. org/10.1037/0021-843X.113.1.155.

Straus MA, Mickey EL. Reliability, validity, and prevalence of partner violence measured by the confict tactics scales in male-dominant nations. Aggress Violent Behav. 2012;17:463–74. https://doi.org/10.1016/j.avb.2012.06.004.

Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB. The revised conflict tactics scales (CTS2) development and preliminary psychometric data. J Fam Issues. 1996;17:283–316. https://doi.org/10.117/019251396017003001.

Suppes T, Leverich GS, Keck PE Jr, Nolen WA, Denicof KD, Altshuler LL, McElroy SL, Rush AJ, Kupka R, Frye MA, Bickel M. The Stanley Foundation Bipolar Treatment Outcome Network: II. demographics and illness characteristics of the frst 261 patients. J Affect Disord. 2001;67:45–59. https://doi.org/10.1176/ appi.ajp.158.3.420.

Tang TZ, DeRubeis RJ, Hollon SD, Amsterdam J, Shelton R, Schalet B. Personality change during depression treatment: a placebo-controlled trial. Arch Gen Psychiatry. 2009;66:1322–30. https://doi.org/10.1001/archgenpsychiat ry.2009.166.

Trespalacios F, Yong Ping E, Serravalle L, and Ellenbogen MA. Social support moderates the development of psychopathology in the offspring of parents with bipolar disorder: a 10-year longitudinal study (in preparation).

Vega EM, O’Leary KD. Test–retest reliability of the revised Confict Tactics Scales (CTS2). J Fam Violence. 2007;22:703–8. https://doi.org/10.1007/s1089 6-007-9118-7.

Whisman MA. Marital distress and DSM-IV psychiatric disorders in a population-based national survey. J Abnorm Psychol. 2007;116:638. https://doi. org/10.1037/0021-843X.116.3.638. Whisman MA, Schonbrun YC. Social consequences of borderline personality disorder symptoms in a population-based survey: marital distress, marital violence, and marital disruption. J Pers Disord. 2009;23:410–5. https://doi. org/10.1521/pedi.2009.23.4.410.

World Health Organization. The World Health Report 2001—Mental health: new understandings, new hope. Geneva: Author; 2001.

Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study. J Clin Psychiatry. 2001;62:849–54. https://doi.org/10.4088/JCP.v62n1103.
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