Abstract
BackgroundIndividuals 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.MethodsParticipants 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.ResultsIntimate 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.ConclusionThis 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.
Highlights
Individuals with bipolar disorder (BD) often possess maladaptive traits and present with various difficulties in psychosocial functioning
Marital difficulties in couples with BD and comorbid personality disorders (PDs) or a partner with major depressive disorder (MDD) were greater than couples with BD only. These findings suggest that the marital adjustment and verbal abuse associated with BD may be driven, in part, by mental disorders other than BD within these couples
In conclusion, adults with BD appear to select intimate partners with similar maladaptive personality traits, ineffective coping skills and who demonstrate high levels of verbal aggression. Both adults with BD and their intimate partners report a paucity of social support
Summary
Individuals with bipolar disorder (BD) often possess maladaptive traits and present with various difficulties in psychosocial functioning. 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. Individuals with BD present with stable maladaptive traits and experience recurring stress which they are unable to effectively cope with and further compounded by low levels of social support. Targeting these factors with effective treatments could potentially improve the course of BD and ameliorate the child-rearing environment. More information is needed about these factors within the family context
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