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Table 1 Overview of longitudinal clinical high-risk studies studying the role of environmental risk factors in the parent–child transmission of mood disorders

From: Environmental factors in offspring of parents with mood disorders and their role in parent–child transmission: findings from a 14-year prospective high-risk study

Article, country, name of study BPD parent type Parent, type of control Age range offspring Diagnostic and environmental measures Environmental factors Offspring of parent with BPD Control offspring Main findings
n (% female) Mean age ± SD n (% female) Mean age ± SD
Koenders et al. (2020), The Netherlands, “The Dutch Bipolar Offspring Study” I, II 12–21 DSM-IV
K-SADS-PL
QFP
CTQ
Childhood trauma
Family functioning
102 (46) 16.0 ± 2.7 Among offspring of parents with BPD, emotional maltreatment (abuse and neglect) was significantly associated with mood disorder development. Due to very low variance on the physical trauma and sexual abuse scales, these were not incorporated in the analyses
No association was found with the family functioning total score nor its subscales
Shalev et al. (2019), USA, “The Pittsburgh Bipolar Offspring Study” I, II w/o BPD dx or w/o any Psychiatric Dx (HC) 7–18 DSM-IV
K-SADS-PL
K-SADS-MRS
K-SADS-P
FACES II
CBQ
Family functioning
Family conflict
481 (50) 15.4 ± 2.6 Offspring of parents w/o BPD dx
162 (51.2)
Offspring of HC parents
175 (52)
Offspring of parents w/o BPD dx
15.5 ± 2.4
Offspring of HC parents
15.5 ± 2.2
Families of parents with BPD and those of parents with non-BPD psychopathology showed lower cohesion and adaptability and higher conflict compared with HC families. There were no significant differences in cohesion and adaptability scores between families of parents with BPD and families of parents with non-BPD psychopathology
In all 3 groups, parent-reported family conflict was significantly higher than child-reported conflict
Iacono et al. (2017), Quebec, Canada I, II w/o any psychiatric Dx, no lifetime mood Dx 4–21 SCID-I
K-SADS-PL
PDI
CBCL
TRF
Parenting practices (support, structure, control) 77 (NR) 8.4 ± 2.5 68 (NR) 12.4 ± 3.2 Parents with BPD showed impairment in parenting practices compared to controls in terms of less support, structure and control to their offspring in middle childhood. Low levels of structure mediated the relation between parental BPD and internalizing and externalizing difficulties during middle childhood. However, low parental control in middle childhood emerged as the strongest mediator of the relation between parental BPD and offspring psychopathology in late adolescence and early adulthood, in terms of substance misuse and depressive disorders among the offspring 12 years later
Kemner et al. (2015), The Netherlands, “The Dutch Bipolar Offspring Study” I, II 12–21 DSM-IV
K-SADS-PL
LEDS
TCI
UCL
Short-EMBU
Stressful life events
Passive coping style
Harm-avoidance temperament
140 (49) 16.0 ± 2.7 Among offspring of parents with BPD, stressful life events were a risk factor for the onset and recurrence of mood disorders. Passive coping style increased the risk of mood episode onset and recurrent episodes, but also altered the effect of life events on the onset of mood disorders by more than 10%, suggesting that having more passive reacting coping-style features enhanced the risk of mood episode onset. The impact of life-events was most pronounced in the early stages of mood disorders. Harm-avoidance temperament also increased the risk of subsequent mood episodes in offspring
Doucette et al. (2016), Canada, “The Canadian Flourish high-risk offspring cohort study” I, II 16–23 DSM-IV
K-SADS-PL
CECA.Q
EAS
LEQ Hollingshead SES Scale Self-report measures of temperament and early adversities
Early childhood adversity Emotionality Exposure to parental BPD Stressful life events 233 (59.7) 16.6 ± 5.6 In offspring of parents with BPD, perceived maternal neglect was a significant early predictor of mood disorders, even after adjusting for further factors, such as exposure to parental BPD. In addition, high offspring emotionality appeared to be associated with the development of mood disorders, also being the possible mediator of the relationship between maternal neglect and the development of mood disorders
Hillegers et al. (2004), The Netherlands, “The Dutch Bipolar Offspring Study” I, II 12–21 DSM-IV
K-SADS-PL
FH-RDC
K-LEDS
FH-RDC
Life event load (time-dependent variable)
Stressful life events 140 (49) 16.0 ± 2.7 Among offspring of parents with BPD, stressful life events increased the liability to mood disorders independently of the familial loading, but the effects slowly diminished over time
  1. BPD bipolar disorder, CBCL Child Behavior Checklist for ages 6–18, CBQ Conflict Behavior Questionnaire, CECA.Q Childhood Experience of Care and Abuse Questionnaire, CTQ Child Trauma Questionnaire, Dx diagnosis, EAS Early Adolescence Temperament Scale, EMBU Swedish acronym for “my memories of upbringing”, FACES-II Family Adhesion and Cohesion Evaluation Scales-II, FH-RDC Family History Related Research Criteria, HC Healthy Controls, K-LEDS Kiddie Life Events and Difficulty Scale, K-SADS-MRS Kiddie Schedule for Affective Disorders and Schizophrenia, Mania Rating Scale, K-SADS-PL Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version, LEDS Life Events and Difficulties Scale, LEQ Life Events and Difficulties Questionnaire, Mood any mood disorder, including bipolar disorder, NR not reported, PDI Parenting Dimensions Inventory, QFP Questionnaire for Family Problems, TCI Temperament and Character Inventory, TRF Teacher Report Form, UCL Utrecht Coping List, w/o without