Parenting and adult mood, anxiety and substance use disorders in female twins: an epidemiological, multi-informant, retrospective study.
TL;DR: In women, parenting behaviour, especially levels of coldness, is probably causally related to risk for a broad range of adult psychiatric disorders, and the shared experience of these three dimensions of parenting predicts a quite small correlation in liability to these disorders in dizygotic twin pairs.
Abstract: Background. Although parenting has long been considered an important risk factor for subsequent psychopathology, most investigations of this question have studied a single informant, clinical populations, one or a few disorders and did not consider relevant covariates. Methods. Three dimensions of parenting (coldness, protectiveness and authoritarianism) were measured by combining the retrospective reports from adult female twins, their co-twins, and their mothers and fathers. We assessed by personal interview, lifetime history in the twins of eight common psychiatric and substance abuse disorders and a range of predictors of parenting. Analyses were performed using logistic regression. Results. Examined individually, high levels of coldness and authoritarianism were modestly but significantly associated with increased risk for nearly all disorders, while the impact of protectiveness was more variable. These associations declined modestly when putative predictors of parenting were added as covariates. Maternal and paternal parenting were equally associated with outcomes in adult daughters. When coldness, protectiveness and authoritarianism were examined together, nearly all significant associations were seen solely with coldness. Few significant interactions were found between maternal and paternal parenting or between coldness, protectiveness and authoritarianism. The shared experience of these three dimensions of parenting predicts a quite small correlation in liability to these disorders in dizygotic twin pairs (e.g. r < 0.04). Conclusion. In women, parenting behaviour, especially levels of coldness, is probably causally related to risk for a broad range of adult psychiatric disorders. The impact of parenting on substance use disorders may be largely mediated through their co-morbidity with major depression, phobias and generalized anxiety disorder. In general population samples, the association of poor parenting with psychiatric illness is modest, largely non-specific and explains little of the observed aggregation of these disorders in families.
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5,680 citations
TL;DR: The underlying structure of the genetic and environmental risk factors for the common psychiatric and drug abuse disorders in men and women is very similar.
Abstract: Background: Patterns of comorbidity suggest that the common psychiatric and substance use syndromes may be divisible into 2 broad groups of internalizing and externalizing disorders. We do not know how genetic and environmental risk factors contribute to this pattern of comorbidity or whether the etiologic structure of these groups differ in men and women. Methods: Lifetime diagnoses for 10 psychiatric syndromes were obtained at a personal interview in more than 5600 members of male-male and female-female twin pairs ascertained from a population-based registry. Multivariate twin modeling was performed using the program Mx. Results: We first fit models to the following 7 syndromes: major depression, generalized anxiety disorder, phobia, alcohol dependence, drug abuse/dependence, adult antisocial behavior, and conduct disorder. The full model, which could be constrained to equality in male and female subjects, identified 2 genetic factors. The first had strongest loadings on alcohol dependence, drug abuse/dependence, adult antisocial behavior, and conduct disorder; the second, on major depression, generalized anxiety disorder, and phobia. Alcohol dependence and drug abuse/dependence had substantial disorder-specific genetic risk factors. Shared environmental factors were most pronounced for conduct disorder and adult antisocial behavior. No clear internalizing/externalizing structure was seen for the unique environmental common factors. We then fit models to 5 internalizing syndromes. The full model, which could also be constrained to equality in men and women, revealed one genetic factor loading most heavily on major depression and generalized anxiety disorder and another loading most strongly on animal and situational phobia. Conclusions: The underlying structure of the genetic and environmental risk factors for the common psychiatric and drug abuse disorders in men and women is very similar. Genetic risk factors predispose to 2 broad groups of internalizing and externalizing disorders. Within the internalizing disorders, 2 genetic factors are seen that predispose to disorders dominated by anxious-misery and fear. Substance use disorders have disorder-specific genetic risks. The externalizing disorders of conduct disorder and adult antisocial behavior are significantly influenced by the shared environment. The pattern of lifetime comorbidity of common psychiatric and substance use disorders results largely from the effects of genetic risk factors. Arch Gen Psychiatry. 2003;60:929-937
1,711 citations
TL;DR: Epidemiological evidence covering prevalence, incidence, course, and risk factors of anxiety disorders among children and adolescents is reviewed for improved early recognition and differential diagnosis as well as prevention and treatment.
1,351 citations
TL;DR: Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders.
Abstract: Context: Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). Objectives: To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. Design: Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. Setting: Munich, Germany. Participants: A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. Main Outcome Measures: Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). Results: Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. Conclusions: Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.
404 citations
TL;DR: The studies reviewed suggest that (1) the heritability of many behavioral traits may be greater in permissive than in restrictive environments and (2) for psychiatric and drug abuse disorders, genes probably work through both traditional within-the-skin physiological pathways and outside- the-skin behavioral pathways.
Abstract: This overview presents selected recent developments in twin studies of adult psychiatric disorders. Subjects examined include the generalizability of heritability estimates, the impact of sex on patterns of familial transmission, gene-environment interaction, twin studies of anxiety and eating disorders, the so-called family environment, special issues raised by twin studies of drug use and abuse, and gene-environment correlation. The studies reviewed suggest that (1) the heritability of many behavioral traits may be greater in permissive than in restrictive environments and, (2) for psychiatric and drug abuse disorders, genes probably work through both traditional within-the-skin physiological pathways and outside-the-skin behavioral pathways. In the latter, genes affect aspects of the social environment, such as exposure to stressful life events and levels of social support, which in turn feed back on risk of illness. Twin studies remain a vibrant part of the field of psychiatric genetics and an important complement to and context for current efforts to localize individual susceptibility genes.
367 citations
Cites background from "Parenting and adult mood, anxiety a..."
...4%.(52) Environmental features of families that are shared by siblings significantly affect risk for psychiatric illness....
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...What proportion of variance in liability to psychiatric illness might be due to components of the shared family environment? We recently addressed this question for parenting behavior.(52) Using the Parental Bonding Instrument,(53) and combining scores from the twin, cotwin, and parent, we showed a moderate relationship among 3 major dimensions of parenting and lifetime risk for 8 common psychiatric and substance use disorders....
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References
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11 Jun 2013
113,134 citations
TL;DR: In this paper, a general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test, therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test.
Abstract: A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should be so divided before using the formula. The index
$$\bar r_{ij} $$
, derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches. Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial group-factor clusters within a subtest. Scalability is not a requisite.
37,235 citations
"Parenting and adult mood, anxiety a..." refers background or methods in this paper
...We examined the internal reliability of our parenting dimensions by Cronbach’s α (Cronbach, 1951) and found that they were modestly lower by parental than by twin report (e.g. for paternal C and A the mean α level for parents and twins were 0±82 and 0±92 and 0±67 and 0±73, respectively)....
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...We examined the internal reliability of our parenting dimensions by Cronbach’s α (Cronbach, 1951) and found that they were modestly lower by parental than by twin report (e....
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...Cronbach’s α level was calculated for all six informants for each dimension separately for mother and father (e.g. for mother’s C, mother on twin1, mother on twin2, twin1 on twin1, twin1 on twin2, twin2 on twin2 and twin2 on twin1) (Cronbach, 1951)....
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...for mother’s C, mother on twin1, mother on twin2, twin1 on twin1, twin1 on twin2, twin2 on twin2 and twin2 on twin1) (Cronbach, 1951)....
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TL;DR: The prevalence of psychiatric disorders is greater than previously thought to be the case, and morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders.
Abstract: Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
11,648 citations
"Parenting and adult mood, anxiety a..." refers background in this paper
...Although high levels of co-morbidity have been consistently observed between psychiatric and substance use disorders (Boyd et al. 1984; Kessler et al. 1994), few studies of parenting have examined the specificity of the association between which individual parenting dimensions and individual disorders....
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...Although high levels of co-morbidity have been consistently observed between psychiatric and substance use disorders (Boyd et al. 1984; Kessler et al. 1994), few studies of parenting have examined the specificity of the association between which individual parenting dimensions and individual…...
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Journal Article•
5,680 citations
"Parenting and adult mood, anxiety a..." refers background in this paper
...Parenting and ‘family environment ’ in twin and adoption studies Several psychodynamic schools as well as the influential attachment theory developed by Bowlby (1980) have posited that the aetiology of most psychiatric disorders lies in deficiencies in parenting....
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...The manner in which parents raise a child has long been thought to be a crucial determinant of that child’s later mental health (Bowlby, 1980; Maccoby, 1992; Perris et al. 1994; Parker & Gladstone, 1996)....
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