IJPP Suresh

See discussions, stats, and author profiles for this publication at: https://www.researchgate.
net/publication/275240598
Family Environment, Coping and Parent-Child Relationship among Families

Raising Children with and without Bipolar Disorder: A Comparative Study
Article in International Journal of Psychology and Psychiatry · January 2015

DOI: 10.5958/2320-6233.2015.00009.7
CITATIONS READS
0 405
2 authors:
Suresh Lukose Abdul Azeez E.P

National Institute of Mental Health and Neuro Sciences Amity University
5 PUBLICATIONS 19 CITATIONS 34 PUBLICATIONS 105 CITATIONS
SEE PROFILE SEE PROFILE
Some of the authors of this publication are also working on these related projects:
development induced displacement and its impact on the lives of Baiga population, Chattisgarh View project
Ethnographic Accounts View project
All content following this page was uploaded by Abdul Azeez E.P on 04 October 2016.
The user has requested enhancement of the downloaded file.

International Journal of Psychology and Psychiatry Vol.3, No. 1, 2015
Doi: 10.5958/2320-6233.2015.00009.7
9.Family Environment, Coping and Parent-Child Relationship among Families Raising

Children with and without Bipolar Disorder: A Comparative Study.
Suresh Lukose1 and E.P. Abdul Azeez2
1.Psychiatric Social Worker, Community Mental Health Programme, Palakkad District, Kerala,
India
Downloaded From IP - 128.128.128.169 on dated 13-Apr-2015
2.Assistant Professor, Department of Social Work, Central University of Rajasthan Ajmer,

Members Copy, Not for Commercial Sale
Rajasthan, India.
www.IndianJournals.com
Childhood bipolar disorder, also known as pediatric bipolar disorder (PBD), is a form of mood
disorder that occurs in children. The significant functional impairments and considerable difficulties
associated with PBD heavy demands are often placed on the resources of parents, which can lead to
decreased quality of family functioning and difficult parent-child relationships. Difficulties in
family function and parent-child relationships have also in other childhood psychiatric disorder
including depression and schizophrenia. The aim of the paper is to know the family environment,
coping and parent-child relationship among families raising children with bipolar disorder in
comparison to normal group. The sample size consists 60 children‘s and their parents, among which
30 children with bipolar disorder and the remaining 30 from normal children‘s (non bipolar) with
age and sex matched normal controls through purposive sampling method. The first category of the
samples was collected from out-patient department of Erna Hoch Centre for Child and Adolescent
Psychiatry of Central Institute of Psychiatry (CIP), Ranchi. The second category (normal controls)
of the samples consist non bipolar children‘s and their parents who resides in the surrounding areas
of the hospital. The family environment and coping scale were administered with parents and the
parent child relationship was assessed from the children‘s. There is higher level of behavioral
problems found in children‘s with Bipolar Affective Disorder compared to normal control group.
Both internalizing and externalizing problems are found in patient group. Statistically significant
associations and differences are found among the parents of children with and without bipolar
118
disorder. The study emphasizes the vulnerability of the families raising children with mental
illnesses.
Key Words: Bipolar Disorder, Family Environment, Parent-Child Relationship, Coping
INTRODUCTION
Childhood bipolar disorder, also known as paediatric bipolar disorder, is a form of mood disorder
that occurs in children. Paediatric bipolar disorder (PBD) is often characterized by a more severe,
remitting, and chronic course of illness compared to cases of adult onset of bipolar disorder
(Biederman et al, 2005). The treatment and management of PBD is often complex due to commonly
occurring disruptions in social, emotional, or cognitive development that can result in significant
and persistent functional disability (Birmaher & Naylor, 2005). Given the significant functional
impairments and considerable difficulties associated with PBD heavy demands are often placed on
the resources of parents, which can lead to decreased quality of family functioning and difficult
parent-child relationships.
Difficulties in family function and parent-child relationships have also been reported in other
childhood psychiatric disorder including depression (Kashani, 1999; Mash & Johnson, 1982).
Moreover, in both of these disorders, problematic parent-child relationships were associated with
poorer clinical outcome (Biederman et al, 1996). The environmental context significantly impacts
the manifestation and clinical courses of PBD, the quality of family functioning can be seen as
either a risk or a protective factor (Miklowitz, 2006). One important consideration in the
determination of negative environmental impact for PBD is the issue of parental psycho-pathology.
A number of investigation have demonstrated high rate of mood disorders among the parents of
PBD and parental mood disorders have been associated with more problematic family functioning.
The effect of family environment on the development of bipolar disorder (BD) in children is
unknown. The characteristics of family with children at high risk for developing bipolar disorder in
order to better understand the contributions of family environment to the development of childhood
bipolar disorder. Bipolar disorder is a familial disorder, which is influenced by genetic and
environmental factors (Althoff et al, 2005). Among the environmental factors considered most
important is the family environment itself.
The exposure to family members who exhibit high expressed emotion (high criticism, emotional
over-involvement and negative affective style) may increase the risk of relapse (Johnson, 2003;
Miklowitz et al, 2004), prolong episode duration (Johnson, 1999) and predict higher levels of mania
and depression at follow-up (Kim & Miklowitz, 2004). Characteristics like insecure attachment and
119
more hostility have been described in relation with a higher incidence of relapse after recovery
(Geller et al, 2000). Other psychosocial stressors interact with genetic predisposition to produce
neurobiological changes that could lead to affective episodes as well as create vulnerability for
future episodes (Post, 1992; Capsi et al, 2003). The family environment provides the most
important resource for supporting the child‘s growth and development. Considering that pediatric
bipolar disorder is associated with severe, chronic impairment in functioning, further exploration is
needed to identify family environment characteristics that could be targets of useful interventions.
There are many research findings which emphasizing the role of different family environmental
factors like; family functioning, family interaction, parent child relationship, parenting strategies,
family belief, attributions, socio-economic status and quality of life on the mental health of children
and adolescents. Studies are repeatedly suggesting the importance of multidimensional strategies for
tackling the mental health problems of children and adolescents. A clear understanding about the
role of different environmental factors on each categories of mental disorder is important.

Recognition and early intervention of maladaptive functioning of different aspects of family

environment is important to promote mental health of young people and the same is important for
prevention and treatment.
METHODS AND MATERIALS
Present study aims to examine the family environment, coping and parent-child relationship in
bipolar disorder among children. The findings would be helpful to identify the role family
environment, coping and parent-child relationship in early onset of bipolar disorder, its maintenance
and plan effective interventions with patients, parents, other family members and prognosis. This
study examined the relationship, socio-demographic variables and severity of illness of family
environment, coping and parent-child relationship of children with bipolar disorder and normal
control. This study is a hospital based cross sectional study and includes 60 children‘s, among
which 30 consist of children with bipolar disorder and their parents and remaining 30 is age and sex
matched normal controls. The first category of the samples were collected from out-patient
department of Erna Hoch Centre for Child and Adolescent Psychiatry of Central Institute of
Psychiatry (CIP), Ranchi, which is a tertiary referral centre for psychiatric patient with a wide
catchment area, including Jharkhand, Bihar, West Bengal, the North Eastern states, UP, MP and
neighborhood countries like Nepal and Bangladesh. The second category (normal controls) of the
samples consist non bipolar children‘s and their parents who resides in the surrounding areas of the
hospital.
120
The inclusion criteria was children diagnosed according to ICD-10 (DCR) criteria (WHO, 1993) for
bipolar disorder, children age between >7 -<18 years and children who stay with their both parents
or at least staying with them from past 2 years. Socio-demographic clinical data sheet, Family
environment scale (Moose and Moose, 2002), Parent-child relationship scale (Rao, 1985), Brief
coping oriented to problem solving inventory (Carver, 1997) and GHQ-12 (Goldberg & Hiller
1979) are used for the study. Parent child relationship scale (Rao, 1989) was administered among
children‘s and all other tools were administered to parents. Appropriate statistical methods were
used for analyzing the data as per SPSS windows version 16.0. Descriptive statistics were used to
describe various sample characteristics. Chi-square test and independent t-test were used to
compare the categorical variables and continuous of two groups respectively. Person correlation
coefficient was used to see relationship among various variables in both groups.
RESULT & DISCUSSION

Socio-demographic Characteristics
The sample of the study constitutes 50% male and 50% respondents were female in both groups, as
we already discussed in the sampling that for the study as we matched the sex of both groups.
Religion is categorized as Hindu and non-Hindu for the better result in the study. It is found that
80% of the patients group d hailing from Hindu religion whereas 20% is non-hind but in normal
control group, 67.34% of them were Hindu religion and 33.66% of the non-Hindu religions. There
were significant differences found in family income in both group at the level of 0.05 (p=0.04) in
the family income. A likely reason could be that in the present scenario, in India majority are from
Hindu religion and belongs to rural background and comes from lower social economic status
(Shaheedha & Nadhiya, 2012). A positive relationship has been found between socio economic
status and vulnerability to mood disorder, with higher rates of vulnerability found among individual
with lower educational and socio achievement levels. The causation hypothesis suggests that the
stress associated with low social position, such as exposure to social adverting and lack of resources
to cope with difficulty, might contribute to the development of mood disorder, whereas the selection
hypothesis argues that genetically predisposed individuals drift down to- or fail to rise out of- such a
position (Jarvis, 1971).
Family Environment
Family environment of the patients and normal control groups were assessed by Family
Environment Scale (Moose & Moose, 2002). We found significant differences at the 0.01 level
121
between the family environment of bipolar children and normal controls; this was also seen by
Belardinelli et al (2008). Family environment of bipolar children showed greater level of
dysfunction in family environment scale. Out result shows that the bipolar children are scored lower
compared to normal controls in various domains of family environment scales. Similar study
findings were reported by (Chang et al 2001; Romero et al 2005) that in patient‘s family all those
domains of family environment scale shows dysfunction. But Cooke et al (1999) reported no
differences found on the family environment scale between bipolar adults and healthy controls. This
finding provides a clear cut indication that the dysfunctional family characteristics related to bipolar
disorder is independent of socio-cultural environments. Whereas patients group scored high in the
domain of conflicts (19.36±2.88) compared to the normal controls. Ferreira et al (2014) found
higher level of conflicts in children with bipolar disorder group (51.6±11.0, 42.2±8.7). This study
also supported by Belardinelli et al (2008) that in family environment scale parents group scored
higher in sub-domain of conflicts.

Table: 01
Family Environment
**p≤0.01 level
Scales Domains Sub Domains Patient Control t df p

group group
M±SD M±SD
Relationship Cohesion 11.53±3.98 9.53±3.24 2.13 58 0.01*
Expressiveness 15.90±4.48 13.26±2.83 2.71 58 0.01*
Conflict 19.36±2.88 17.00±3.80 2.71 58 0.01*
Independent 15.10±2.48 11.40±2.67 5.55 58 0.66
Achievement 13.86±2.72 12.96±1.88 1.48 58 0.19
orientation
Intellectual cultural 14.30±3.17 13.46±4.18 0.86 58 0.01*
Personal
Family environment
orientation
growth Active recreational 14.90±2.68 14.36±2.44 0.80 58 0.01*
organization
Moral religious 12.16±3.24 11.16±3.54 1.13 58 0.77
emphases
System Organization 10.56±3.49 10.36±5.10
0.17 58 0.01*
maintenance Control 12.16±2.91 13.00±1.80
- 58 0.01*
1.33
Families‘ of children with bipolar disorder shows lower level of active recreational and cultural
orientation while comparing to normal control group. The previous studies also found the same
(Belardinelli et al 2008). Families with bipolar children show dysfunctional pattern related to
interpersonal interactions and personal growth. This lack of interpersonal interactions and personal
122
growth may be due to the distressed family environment. Patient group organization in the sub-
domain of family environment negatively correlated with clinical characteristics of age of onset
significantly 0.05 levels (-.37). Organizational ability is one of the components of leadership and
relationship of leadership with age has already been discussed in the light of study done by
Oshagbemi (2003). The stress of having child with emotional and behavioral problem or age of
onset implies changes in family organization in order to respond adaptively (Moffit, 1993). In the
total number of episode negative correlation find out the sub domain of active recreational
orientation and control (r= -.39, r= -.44). In the study Belardinelli et al (2008) studied the family
environment pattern in families with bipolar children and their study shows the negative correlation
between the sub domains of cohesion and active recreational orientation of admission in control (r=-
.43).
Parent-child Relationship
For measuring the attachment of child with their parents, parent Child Relationship Scale (Rao,
1985) was used. There were significant differences found in parent child relationship of children
with bipolar disorder and normal control group. Patient group attachment with father side, scored
higher compared to the normal control group in various domains of parent child relationship scale.
A similar study finding was reported Bruno and Cuuppola (2004) found lower attachment security
in samples of children‘s with various medical and developmental problems. In mother child
relationship it was found that mothers are more attached with their children especially in sub
domain of loving (33.63±36.±33), protecting (36.03±38.43) and symbolic reward (33.86±32.16).
Also significantly the patient group receiving higher amount of object punishment (25.86±4.46),
demanding (28.50±3.95) and indifferent (29.50±4.99) from the mother side compared to the normal
control. The result shows that negative parenting in patient group is lesser than that of normal
control group. Findings of current study can be more than episodes of mood disorder, parents may
be afraid of a protecting them highly in order to keep their children away from the disorder or
vulnerable circumstances. Those findings suggest that there are significant differences in the father,
and mother attachment towards their child. More over it is also found that there is no difference in
parents attachment towards their children based upon their gender.
Table: 02
Comparison of Parent-Child Relationship with Patients and Normal Control Group (Father)
Parent-Child Patient Control group t df p
Relationship Scale group M±SD
M±SD
Protecting 36.33±2.55 40.53±4.71 -4.285 58 0.01**
Symbolic punishment 32.33±2.94 23.80±5.60 7.38 58 0.05*
123
Rejection 29.76±4.59 20.36±6.61 6.39 58 0.22

Objective punishment 29.10±5.29 19.60±7.31 5.76 58 0.29
Demanding 32.10±3.31 19.63±6.38 9.48 58 0.00**

Indifferent 32.66±4.36 27.00±3.93 5.28 58 0.88
Symbolic reward 36.00±3.43 34.00±6.26 1.53 58 0.00**
Love 34.26±3.56 41.03±7.38 -4.52 58 0.00**

Objective reward 30.13±4.42 40.00±6.81 -6.65 58 0.11
Neglecting 34.46±3.18 22.53±5.39 10.43 58 0.15

*p≤0.05, **p≤0.01
Most of the study revealed that lower attachment, warmth, lower maternal care is significantly
found in children with bipolar disorder (Miklowitz & Chang, 2008). Present study suggests that
instead of having a higher level of components of attachment; patient group is showing
comparatively lower attachment level than normal control group. This may be due to two factors.
First, it can be part of high expressed emotion. Another reason can be the occurrence of one or more
episodes makes the parents be-aware of having another episode due to low attachment and warmth.
This may be a protective factor against another episode also.

Table: 03
Comparison of Parent-Child Relationship with Patients and Normal Control Group (Mother)
Domains Patients group Control group t df p
M±SD M±SD
Protecting 36.03±3.36 38.43±6.15 -1.87 58 0.02**

Symbolic punishment 29.03±4.01 24.16±2.94 5.35 58 0.22
Rejecting 26.83±4.29 19.96±5.06 5.66 58 0.73

Object punishment 25.86±4.46 22.13±6.03 2.72 58 0.04*
Demanding 28.50±3.95 25.13±6.54 2.41 58 0.00***
Indifferent 29.50±4.99 26.73±3.31 2.52 58 0.01**
Symbolic reward 33.86±4.28 32.16±6.39 1.21 58 0.04*
Loving 33.63±3.47 36.33±7.73 -1.74 58 0.00***
Object reward 29.33±4.49 35.50±5.39 -4.81 58 0.79
Neglecting 30.43±4.01 22.13±5.17 6.93 58 0.33
*p≤0.05, **p≤0.01
The domain of object reward (-.38) was negatively associated with total number of episode and type
of episode. Family stress has been operationalized as whether or not the patient resides with
relatives characterized by expressed emotion attitudes (Brown et al 1972). High expressed emotion
refers to high level of criticism, hostility, and /or emotional over-involvement from a care relative
(typically a parents or spouse) during an immediately following a parents acute episode of illness.
124
Patients with schizophrenia, bipolar disorder, or recurrent major depressive disorder who returns
home to high expressed emotion families following an acute episode are two to three times more
likely to relapse in the subsequent 9 months than are patients who return to low expressed emotion
families (Barrowclough & Hooley, 2003; Miklowitz, 2004). The domain of loving is negatively
correlated with number of admission. Schenkel et al (2008) found the parent child relationships in
the bipolar children characterized by significantly less warmth, affection, and intimacy, and more
quarreling and forceful punishment and an earlier age of onset, living in a single parent home, and
the presence of a parental mood disorder were associated with greater parent-child relationship
difficulties.
Coping Strategies of Parents
Coping is constantly changing cognitive and behavioral effort to manage specific external and /or
internal demands that are appraised as taxing or resources of the person. Here there were significant
differences found on problem focused coping which include active coping (4.83±6.33). This
findings supported (Scazufca & Kuipers, 1999) that problem focused coping was more used among
relatives of patient with schizophrenia. Similarly, Chakraborty and Gill (2002) found that problem
focused coping was used by caregivers of bipolar parents. Patient group tend to use more coping
strategies than healthy controls.
Table: 04
Coping Strategies
BRIEF-COPE Patient group Control group t df p
M±SD M±SD
Self direction 4.50±0.90 6.90±1.09 -9.27 58 0.45
Active coping 4.83±0.98 6.33±1.47 -4.64 58 0.01**
Denial 5.10±0.95 2.80±0.80 10.05 58 0.08
Substance abuse 5.10±1.18 2.43±0.62 10.90 58 0.01**
Emotional support 4.40±0.72 2.73±0.90 7.86 58 0.57
Instrumental 4.16±0.98 2.86±0.89 5.33 58 0.65

support
Behavioral 4.66±0.75 7.13±0.89 -11.48 58 0.34
disengagement
Venting 4.33±0.81 2.53±0.73 9.49 58 0.83
Positive reframing 4.60±0.62 6.83±1.11 -9.57 58 0.01**
Planning 4.20±0.96 6.90±1.21 -9.55 58 0.22
Humor 3.86±1.47 7.03±0.85 -10.16 58 0.00**
Acceptance 4.16±0.79 7.13±0.93 -13.24 58 0.13
Religious coping 4.36±1.09 7.20±0.88 -10.99 58 0.34
Self blaming 4.43±0.85 2.46±0.50 10.80 58 0.01**
**p≤0.01
125
Carver and Smith (2010) also reported maladaptive coping styles were normally used by patient‘s
caregivers to handle the day to day stress, anxiety and from social stigma. Further in this study
statically significant differences was found in substance abuse (5.10±1.18), self blaming
(4.43±0.85) and humor (3.86±1.47), patients group tend to use this kind of coping frequently is
compared to normal controls. Studies related to coping skills of caregivers of patient with mental
illness reveals that emotion focused coping was more commonly used by schizophrenia patients and
problem focused coping was used by bipolar patients (Chakraboty & Gill, 2002). In present study it
was also noted that there was a significant negative correlation between the numbers of episode. It
means magnitude of illness an influencing factor to control the truthfulness of parents to come up
with more accurate and authentic information regarding this child‘s illness. Here negative
correlation means if the magnitude of illness is hiked up then parents tend to be more truthful about
their children illness. Also the domain of active coping (r=-.36) and humor (r=-.42) are negatively
correlated with total number of episode. Chakraborty and Gill (2002) compared the coping
strategies used by caregivers of bipolar patients. The result indicated emotion focused coping was
more commonly used by caregivers of bipolar patients.
Conclusion
The study shed light up on the increased vulnerabilities of children‘s with bipolar disorder and their
parents. Significant differences are visible in the level of coping and family environment of children
with and without bipolar disorder. The study shows that parents with bipolar children are very prone
to have negative coping strategies while compared to the normal group. Negativity in coping effects
the family environment and parent child relationship and further it are leading factor for the
expressed emotions and relapse or decreased chances of good prognosis. Variables under this study
are interrelated and a cause and effect relationship has been seen with between and among the
variables including the socio-demographic characteristics. This study is emphasizing that there is a
significant need to address the psychosocial issues of children‘s with bipolar disorder and their
family members. Apart from the psychosocial education, intervention programmes should focus on
family environment, coping and parent child relationship too.
Reference
1. Althoff, M., Romero, R. H., & Raichart, B.K. (2005) Family environment factors in families
with bipolar children. Journal of Affective Disorder, 299-305.
2. Barrowclough, C. & Hooley, J. M. (2003) Review attributions and expressed emotion: A
review. Clinical Psychology Review, 23(6), 849-880.
126
3. Belardinelli, C., Hatch, J. P., Olvera, B. L., Fonseca, M., Caetano, S. C., Nicoletti, M., Pliszka,
S., Soares, J. C. (2008) Family environment patterns in families with bipolar children. Journal
of Affective Disorder, 107(1-3), 299-305.
4. Biederman, M. D., Faraone, S. & Mick, B. A. (1996) Attention-deficit hyperactivity disorder
and juvenile mania: an overlook comorbidity. Journal of American Academy of Child and
Adolescent Psychiatry, 35, 997-1008.
5. Biederman, M. D., Spencer, T. & Mick, E. (2005) Bipolar disorder in children: misdiagnosis,
underdiagnosis, and future directions. Journal of American Academy of Child and Adolescent
Psychiatry, 34, 709-714.
6. Birmaher, J. & Naylor, A. K. (2005) Treatment of bipolar disorder in children and adolescent.
Journal of Affective Disorder, 20, 76-78.
7. Brown, J. W., Birley, J. L., Wing, J. K. (1972) Influence of family life on the course of
schizophrenic disorders: A replication. British Journal of Psychiatry, 121(562), 241-258.

8. Bruno, B. & Cuppola, G. (2004) Mother-child attachment and pre-school behavior problems in
children with developmental delays. Journal of Family Psychology, 12, 35-45.

9. Capsi, A.H. (2003) Stress-indicative pattern of nonverbal communication: Their role in family
interaction. British Journal of Psychiatry, 18, 103-113.
10. Carver, C. S. & Smith, J. C. (2010) Personality and coping. Annual Review of Psychology, 61,
679-704.
11. Carver, C. S. (1997) ‗Brief COPE‘. International Journal of Behavioral Medicine, 4, 92-100.
12. Chakrabothy, S. & Gill, S. (2002) Coping and its correlates among caregivers of patients with
bipolar disorders: A preliminary study. Bipolar Disorders, 4, 92-100.
13. Chang, K. D., Blasey, C., Ketter, T. A., Steiner, H. (2001) Family environment of children and
adolescents with bipolar parents. Bipolar Disorder, 3, 73-78.
14. Cooke, R. G., Young, L. T., Mohri, L., Blake, P. Joffe, R. T. (1999) Family-of-origin
characteristics in bipolar disorder: a controlled study. Canadian Journal of Psychiatry, 44, 379-
381.
15. Ferreira, G. S., Moreira, C. R., Klienman, A. (2014) Inter-relatedness of marital relations and
parent-child relations: A Meta analytic review. Psychological Bulletin, 118, 108-132.
16. Geller, B., Bolhofner, K., Craney, J. L., Williams, M., DelBello, M. P., Gunderson, K. (2000).
Psychosocial functioning in prepuberal and early adolescent bipolar disorder phenotype.
Journal of American Academy of Child and Adolescent Psychiatry, 39, 1543-1548.
127
17. Goldberg, D. P. & Hiller, V.F. (1979) A scaled version of the general health questionnaire.
Psychological medicine, 9.139-145.
18. Jarvis, J. T. (1971) Intervention and reflection: Basic issues in medical ethics. Philosophy and
Public affairs, 1, 61-80.
19. Johnson, S. L. (2003) ‗Psychopathology and the treatment of bipolar disorder‘. Annual Review
of Clinical Psychology, 2, 119-125.
20. Kashani, J.H. (1999) ‗Perceived family characteristic difference between depressed and anxious
children and adolescents‘. Journal of Affective Disorders, 29, 269-274.
21. Mash, E J., & Johnson, C. (1982). ‗A comparison of mother child interaction of younger and
older hyperactive and normal children‘. Child Development, 53, 1371-1381.
22. Miklowitz, D. J. & Chang, K. D. (2008) Prevention of bipolar disorder in at-risk children:
Theoretical assumptions and empirical foundations. Development and Psychopathology, 16(3),
667-688.
23. Miklowitz, D.J (2006). ‗New psycho-social interventions for bipolar disorder: A review of the
literature and Introduction of the systematic treatment enhancement program‘. Journal of

Cognitive Psychotherapy, 20, 215-230.
24. Milklowitz, D.J. (2004) ‗Family focused treatment for adolescent with bipolar disorder‘.
Journal of Affective Disorders, 82, 113-128.
25. Moffitt, T. E. (1993) Adolescence-limited and life-course-persistent anti social behavior: A
developmental taxonomy. Psychological Review, 100, 674-701.
26. Moose, R. & Moose, B. (1974) ‗Measure the social-environmental characteristics of all types of
families‘. Family Environment Scale Manual.
27. Moose, R. H. & Moose, B. S. (2002) Family environment scale manual. Development,
Application, Research, 3rd Ed. Centre for Health care Evaluation, Department of Veterans
Affairs and Stanford University Medical Centers, Palo Alto, California.
28. Oshagbemi, T. (2013) Age influences on the leadership styles and behaviors of managers.
Employee Relation, 26, 19-26.
29. Post, A.G. (1992) ‗Targeting family interaction behavior and high expressed emotion in the
psycho social treatment of bipolar disorder‘. Psychotherapy in Practice, 4, 25-28.
30. Rao, N. (1985) Manual for parent child relationship scale. Agra: National Psychological
Corporation.
128
31. Romero, S., DelBello, M. P., Soutullo, C. A., Stanford, K., Strakowski, S. M., 2005. Family
environment in families with versus families without parental bipolar disorder: a preliminary
comparison study. Bipolar Disorder, 7, 617-622.
32. Scazufca, M & Kuipers, E. (1999) Coping strategies in relatives of people with schizophrenia
before and after psychiatric admission. British Journal of Psychiatry, 174, 154-158.
33. Schenkel, L. S., West, A. E., Harrel, E. M et al (2008) parent-child interactions in peadiatric
bipolar disorder. Journal of Clinical Psychology, 64, 422-437.
34. Shaheedha, S. & Nadhiya, H. M. (2012) A comparative study on Adolescent-parent relationship
among boys and girls in rural setting. Studies on Home and community Science, 6 (2), 121-125.
35. World Health Organization (1993) The International classification of mental and behavioral
disorders (DCR, 10th revision). WHO: Geneva.
129
View publication stats

IJPP Suresh

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

IJPP Suresh

Uploaded by

Copyright:

Available Formats

See discussions, stats, and author profiles for this publication at: https://www.researchgate.

Family Environment, Coping and Parent-Child Relationship among Families

Article in International Journal of Psychology and Psychiatry · January 2015

Suresh Lukose Abdul Azeez E.P

SEE PROFILE SEE PROFILE

Ethnographic Accounts View project

The user has requested enhancement of the downloaded file.

9.Family Environment, Coping and Parent-Child Relationship among Families Raising

2.Assistant Professor, Department of Social Work, Central University of Rajasthan Ajmer,

role of different environmental factors on each categories of mental disorder is important.

Recognition and early intervention of maladaptive functioning of different aspects of family

RESULT & DISCUSSION

higher in sub-domain of conflicts.

Scales Domains Sub Domains Patient Control t df p

Rejection 29.76±4.59 20.36±6.61 6.39 58 0.22

Demanding 32.10±3.31 19.63±6.38 9.48 58 0.00**

Love 34.26±3.56 41.03±7.38 -4.52 58 0.00**

Neglecting 34.46±3.18 22.53±5.39 10.43 58 0.15

This may be a protective factor against another episode also.

Protecting 36.03±3.36 38.43±6.15 -1.87 58 0.02**

Rejecting 26.83±4.29 19.96±5.06 5.66 58 0.73

Emotional support 4.40±0.72 2.73±0.90 7.86 58 0.57

Instrumental 4.16±0.98 2.86±0.89 5.33 58 0.65

more commonly used by caregivers of bipolar patients.

schizophrenic disorders: A replication. British Journal of Psychiatry, 121(562), 241-258.

children with developmental delays. Journal of Family Psychology, 12, 35-45.

literature and Introduction of the systematic treatment enhancement program‘. Journal of

View publication stats

You might also like