Shared Stressors and Disorders in Families

Studies have consistently shown that both stressors and disorder congregate within families and that these provide simultaneous, as well as later, life risks for both parents and children. Not only do family conflicts and severe events increase the risk of disorder in both, but there is also evidence that disorder in parents provides additional risk for children, and vice versa.

Although most studies have shown links between mothers’ and children’s disorder, associations have also been shown with the fathers’ psychological disorder. Disorder in both parents increases the risk for the children substantially. Contributory risk factors from mothers include a history of affective disorder, current depressed symptoms, vulnerability characteristics, and ongoing chronic stressors, all of which play a part in the children’s disorder.

Although chronic stressors predict children’s disorder independently of mental illness in the parents, the accompanying maternal impairment and poor parenting are associated with higher negative outcomes. This is likely because common stressors (e.g., marital conflict) affect the mothers and children and, in addition, mothers who are depressed are emotionally unavailable as a protective influence to help the children to cope.

Thus, without the buffering effect of maternal support, the children are additionally susceptible to stress and can become symptomatic. The role of types of family stressors, family structure, sibling stressors, parenting, and parental disorder in familial patterning of stressors is now examined.

Types of Family Stressors. The types of family stressors that have proved to be important in predicting disorder in children involve family conflict and parental loss and bereavement. Children in families with parental affective disorder experience more acute stressful events, particularly those of an interpersonal nature, than children with parents with other problems, such as medical illnesses. However, chronic stressors are equally high in both.

The mothers’ disorder itself also acts as stressor for the children, thereby increasing risk. Children’s responses to stressors is another contributor to risk, with negative self-concept being not only more common in children with higher numbers of stressors but also increasing the risk of disorder, particularly depression.

These negative cognitions are associated with criticism and noninvolvement by the mothers. Although little work has been done on the agency of the stressors, aspects of both stress agency and stress carrying are likely to be present in the parents and children, consistent with the disorders and associated vulnerability.

Family Arrangements. Nontraditional family structures following the loss of a biological parent have been examined in relation both to stress and parenting and to its differential effects on siblings raised together and raised apart explored.

Siblings brought up apart in different family arrangements show the greatest difference in adjustment, although even siblings raised together show different responses to family conflict and stressors. Studies agree that the loss of parents affects children differentially, even when objective aspects of the loss are assessed. Poor parenting in terms of neglect and physical abuse are more common in certain family structures, such as when a biological and step-parent are present.

Sibling Stressors. Siblings’ experiences have mainly been studied in the context of genetic studies to identify the sources of shared and nonshared environments to help explain the differences and similarities between siblings. These have used a variety of research strategies involving family studies, adoption studies, and twin studies to look at variations between siblings in personality, disorder, and experience of parenting.

Interestingly, siblings have been shown to be largely different from one another in most assessments, and thus a large focus of such studies has been on assessing the role of the nonshared environment in explaining experience, personality, and psychopathology. The reasons for differences in siblings’ environments include their relative ages, position in the family, gender, extrafamilial experience such as school and social experience, and more random accidental or idiosyncratic experience.

Although less work has been conducted on the degree to which stressors are shared by siblings, studies that do exist show a high degree of sharing of life events but less sharing of the negative impact of these events. Thus only approximately one-third of events held in common have a similar degree of negative impact for different family members. Twin studies have shown there to be a high degree of concordance for severe life events and a greater impact of such events in monozygotic than dizygotic twins.

In the late 1990s, an approach opposing the importance of family stressors emphasized the importance of children’s experiences outside the family. Nonshared environmental influences in terms of school and social life were postulated as the critical environmental influences on child development and disorder, with familial influences being accounted for by genetic inheritance. Thus, sibling comparisons examining nonshared and usually nonfamily-based stressors, as well as positive experiences, have also been investigated.

Parenting. The quality of parenting has mainly been assessed around issues of the care and control of children. Poor parenting involves low levels of care and high control; at one extreme, this can involve the neglect and abuse of children. Parenting styles have also been categorized as authoritative, authoritarian, permissive, and disengaged, with the first of these being the most adaptive and related to positive child development.

At the more extreme levels of poor parenting, involving neglect and physical abuse, there is a high degree of shared experience among same-sex siblings. But where cold or critical parenting is involved, differential treatment by parents is much more common. with both favoritism and scapegoating of individual offspring occurring quite frequently.

A process model of parenting shows the effects of the parents’ own early development and personality, adult work history, marital relationship, and social network on parenting. This, in turn, impacts on child development and characteristics.

Parent Disorder. Psychiatric disorder in the parents can act as a magnet for familial stress, both in provoking the disorder and in perpetuating it. There is a strong relationship between concurrent disorder in parents (particularly mothers) and children. However, the chronicity and severity of the impairment by the disorder are more highly related to child’s adjustment than to the actual parental diagnosis.

Although the fathers’ diagnoses exert weaker effects than mothers’, the presence of disorder in both parents substantially increases the likelihood of disorder in the offspring. Because adults with depression have a higher likelihood of being partnered by people who have a psychiatric disorder, the likelihood of two parents being affected increases. Thus, 25% of husbands of women with depression have been shown to have disorders themselves, and as many as 41% of wives of men with a psychiatric diagnosis were similarly affected.

This is argued to occur not only through assortative pairing, whereby individuals with a disorder appear to select partners with a similar impairment but also through the subsequent development of a disorder in the partner of an affected individual. This may be due to existing spousal difficulties or to the psychiatric disorder in both being caused by prior conditions in the family, such as poverty or conflict.