Is mental illness hereditary , In alot of family it seems to be?

Answer 1

The aberrant physiology that can cause some mental problems seems to be hereditary.

My father suffered from paranoid delusions.
My sister has had emotional problems all her life, although her particular problem is not easily diagnosed.
My youngest brother has delusions of grandeur, and is heading towards setting himself up as the next Jim Jones (no, I kid you not. You people in Alberta who live near him should be VERY AFRAID.)

The rest of us have turned out normal mentally.

Answer 2

Some are. Nature or nurture is the question. When you're raised by unhealthy people, you tend to get unhealthy ideas about how to live your life, view yourself, the world... practice unhealthy habits... When you live with someone who is depressed, you tend to get depressed yourself... that can also happen with other mental and emotional illnesses whether or not you inherited the tendency.

Answer 3

Yes

Answer 4

There is at least a genetic predisposition. Some may be environmental as well. This is a complicated set of disorders and it is hard to exactly classify.

Answer 5

yup my wholle family has some kind or another mental illness

Answer 6

I'm sure it is since it seems to be that way in my family.

Answer 7

YES IT IS PASSED BY THE PARENTS TO THE CHILDERN
Having a Parent with Mental Illness: Child Outcomes

CRITICAL ISSUE: Research indicates that children who have a parent with mental illness are more likely to develop psychosocial difficulties. Studies, however, have focused primarily on elaborating sources of risk, rather than identifying sources of resilience. Mental illness in parents interacts with, or is associated with many variables and processes that can confer risk upon or enhance the resilience of children. No attention has been paid to children's subjective experiences or reports of what is useful to them in coping with their families' circumstances.

Research on Outcomes for Children
Two decades of research have unequivocally indicated that children who have a parent with mental illness are at significantly greater risk for multiple psychosocial problems (Beardslee et al., 1996a; Canino, Bird, Rubio-Stipec, Bravo & Algeria, 1990; Oyserman, Mowbray, Meares & Firminger, 2000). Studies have noted rates of child psychiatric diagnosis among offspring ranging from approximately 30% to 50% (Canino et al.; Oyserman et al.), as compared to an estimated rate of 20% among the general child population (Friedman, Katz-Leavy, Manderscheid, & Sondheimer, 1996). These same children are more likely to show developmental delays, lower academic competence, and difficulty with social relationships (Barocas, Seifer, & Sameroff, 1985; Oyserman et al.; Sameroff & Seifer, 1983; Weintraub & Neal, 1984). Despite these risks, many children of parents with mental illness are resilient and appear to "avoid" significant problems (Beardslee & Poderofsky, 1988).

Why do some children exposed to parental illness do well while others struggle? Active research in the area has revealed that mental illness itself does not guarantee poor outcomes. Instead, mental illness in parents interacts with, or is associated with many variables and processes that can enhance resilience or confer risk upon children (Downey & Coyne, 1990; Goodman & Gotlib, 1999). Thus, there are many potential avenues for intervention, and research is beginning to turn its attention to these important issues.

It is important to note that the research on child outcomes has been limited in several ways. The majority of studies have focused on white, middle-class families in which the mother has an affective disorder diagnosis. Thus, our understanding of the processes of risk and resilience, and appropriate related interventions, is limited with respect to other diagnoses, among more diverse families. Similarly, little is known about cultural and ethnic differences in the relationship of parental mental illness and child outcomes (Oyserman et al., 2000).

Pathways of Influence
In a recent review of the literature on the risk for psychopathology among children of depressed mothers, Goodman and Gotlib (1999) define a model that provides a useful framework for the current discussion. Although their model focuses on "risk" for poor outcomes, i.e., psychopathology, it provides a framework for discussing both risk and resilience among children who have a parent with mental illness.

Based on existing data, Goodman and Gotlib (1999) identify pathways between parent diagnosis of depression and child outcomes that involve multiple mediating and moderating processes. Mediators explain why, or through what mechanisms, parental mental illness is related to child outcomes, while moderators influence the quality of the relationship, or to what degree parental mental illness impacts child outcomes (Baron & Kenny, 1986). Specifically, Goodman and Gotlib (1999) propose that parental depression is related to several "mechanisms of risk" (i.e., mediators) that result from parental depression. These confer vulnerability on the child that ultimately leads to psychopathology. In addition to these mediating factors, the authors list moderating factors that interact with mediating variables to increase risk for child vulnerability and negative outcomes (Goodman & Gotlib, p. 461). Moderators distinguish between different subgroups of families in which a parent has a mental illness. For example, availability of a father without mental illness in the context of maternal mental illness can enhance child outcomes, such that families with a second parent do better, and single-parent families do worse (Oyserman et al., 2000). Availability moderates the relationship of parental mental illness and child outcomes.

Mediators of the Relationship of Parental Mental Illness and Child Outcomes
Genetic Influences. Research clearly indicates that certain mental illnesses run in families (Hammen, 1991; Kendler & Diehl, 1993). This is true whether studies begin with a cohort of adults with psychiatric diagnoses and examine rates of diagnosis among their children; or with a cohort of children with diagnoses and examine rates of mental illness or symptomotology among parents. There may also be specificity for transmission of diagnosis from parents to children. Children of parents with affective disorders are more likely to manifest affective disorders than other disorders, children of parents with an anxiety disorder are more likely to manifest anxiety disorders, and children of parents with both depression and anxiety are more likely to manifest similar comorbidity (Biederman et al., 2001; Warner, Mufson, & Weissman, 1995; Weissman, 1989).

The strong evidence for increased prevalence of diagnosis within families does not however, "prove" heredity of mental illness. It is difficult to tease out genetic from environmental influences in families where both genes and environment are shared. Risk for diagnosis among children may result from the stressful and disruptive environment potentially created by a parent's illness, a child's illness, or the multiple stressors (e.g., family disruption) that co-occur with psychiatric diagnoses for both adults and children (Silverman, 1989). Thus, research strategies that can distinguish between genetic and environmental influences are necessary to understand the relative role of these two factors. Recent research has begun to employ such strategies.

Twin and adoption studies are generally considered the "gold standard" in genetic research. Both have supported a unique role for heredity in the transmission of mental illness from parent to child. Twin studies have shown that monozygotic twins who share identical genetic structure, show significantly higher concordance rates for schizophrenia (Hanson, Gottesman & Meehl, 1977), and anxiety (Andrews, Stewart, Allen, & Henderson, 1990) than dizygotic twins, who share no more genetic similarity than any siblings. Adoption studies further reveal that adopted-away children of parents with schizophrenia (Kendler & Gardner, 1997; Tienari, Wynne, Moring & Lahti, 1994) and anti-social personality (Mason & Frick, 1994) disorder are at greater risk for these or related diagnoses, respectively, than adopted-away children whose parents did not have these diagnoses. However, a large study of adopted children in Finland (Tienari et al.) showed that risk for schizophrenia may result from an interaction between genetic predisposition and difficult adopted-family environment.

Using a complementary strategy of investigation, Todd et al. (1996) have examined extended families of adults with affective illnesses. They found that risk for diagnosis was greater among first-degree relatives and offspring, compared to second and lesser degree relatives. In addition, they found that bipolar disorder showed stronger heritability than unipolar depression.

Biological Influences. There is growing support that children of parents with mental illness may be constitutionally vulnerable at birth. Infants of mothers with schizophrenia have been found to be at greater risk for fetal and neonatal death, and more vulnerable to negative consequences resulting from obstetrical complications (Walker & Emory, 1983). Similarly, infants of mothers with depression have shown greater delivery complications, lower Apgar scores, lower tonus and less self-quieting ability (Sameroff, Barocas, & Seifer, 1978). Psychiatric diagnoses are also associated with biochemical dysregulation (Goodman & Gotlib, 1999). Recent investigations have supported the possibility that maternal dysregulation or its effects during pregnancy may influence neuroendocrine dysregulation in infants. This dysregulation may be related to emotional and behavioral functioning during infancy and to the development of later emotional and behavioral problems (see Goodman & Gotlib for review). For example, studies of depressed, pregnant women have found that levels of hormones associated with depression and stress were abnormally elevated during pregnancy (Goodman & Gotlib; Smith et al., 1990). A single study (Glover, Teixeira, Gitau, & Fisk, 1998) indicated in addition, that variation of fetal levels of one of these hormones, cortisol, was explained by maternal levels at 20 to 36 weeks of pregnancy. Thus, maternal cortisol levels were related to fetal levels. However, Goodman and Gotlib (1999) caution that the link between exposure to neuroendocrine dysregulation and outcomes needs to be confirmed in additional studies, and the link between immediate outcomes and development of later psychopathology needs further investigation.

In addition to neuroendocrine abnormalities, the presence of mental illness during pregnancy may compromise a mother's health behaviors and prenatal care that, in turn, may result in a less nurturing fetal environment and biological transmission of risk (Goodman & Gotlib, 1999). It is important to reiterate that the choices of mothers with mental illness about health behaviors during pregnancy are complicated, and may be as strongly related to stigma and fear of loss of custody, as they are to the presence of mental illness (Nicholson, 1996; Nicholson et al., 1998a, 1998b).

Illness Characteristics. The relationship of specific parental diagnoses to child outcomes is unclear. Early studies found no lasting differences on a variety of child outcomes across different diagnoses (Sameroff & Seifer, 1983). However, newborns of depressed women showed worse outcomes on obstetrical status and neonatal autonomic functioning than newborns of women with schizophrenia, causing speculation that children of depressed mothers may be at greatest risk (Sameroff & Seifer). By contrast, a more recent study revealed that mothers with schizophrenia showed weaker parenting skills than mothers with affective disorders, suggesting that these children may be at greater risk (Goodman & Brumley, 1990; Oyserman et al., 2000). Most evidence, however, indicates that severity of symptoms, chronicity of illness, and lower adaptive functioning of parents are more closely related to poor child outcomes than are particular diagnoses (Sameroff et al., 1978; Sameroff & Seifer; Warner et al., 1995). Other parental illness characteristics that have been found to be predictive of worse outcomes include earlier age at onset of parental depression (prior to 30 years old), and comorbidity of depression and anxiety (Warner et al.; Wickramaratne & Weissman, 1998).

Environmental Influences. Non-genetic and non-biological factors also play important mediating roles in the transmission of risk for and resilience to psychiatric diagnosis (Silverman, 1989). In particular, research has identified important individual and family characteristics that are associated with parental mental illness and child outcomes. Most notably, these include parenting behavior, marital or partner relationship, and family functioning.

Numerous studies suggest that parenting behavior is affected by the presence of mental illness, and that parenting has a strong influence on child outcomes. Research indicates that mothers with mental illness show a range of difficulty with parenting, and that these difficulties may differ somewhat as a function of diagnosis. Mothers with schizophrenia and affective disorder diagnoses both show decreased verbal and emotional responsiveness compared to well parents (Goodman & Brumley, 1990). Mothers with schizophrenia appear to express less anger and hostility than either well mothers or mothers with depression (Goodman & Brumley), while mothers with depression have been found to express greater levels of hostility that well mothers (Goodman & Gotlib, 1999). In addition, mothers with depression exhibit latent, less contingent responses, increased expression of sadness, and irritability, and less expression of positive emotions (Goodman & Gotlib).

These parenting characteristics in turn, have been shown to be associated with poorer attachment (Radke-Yarrow et al., 1995), and developmental delays in language, attention, and social competence among infants and toddlers (Goodman & Brumley). Additional work with depressed mothers has indicated that they tend to withdraw from confrontation and conflict with children, rather than engage in negotiation (Kochanska, Kuczynski, Radke-Yarrow & Welsh, 1987), and that depressed affect in mothers may influence decreased expressions of anger by other family members including children. Such parenting styles may influence the development of maladaptive coping styles and interpersonal skills associated with depression and anxiety in children (Goodman & Gotlib). More research is needed to support links between specific parenting behaviors and specific child outcomes.

Depressed mothers also show differences in cognitive processing from non-depressed mothers. Parents with depression engage in more negative information processing, and are more likely to have negative attribution styles and to evaluate themselves poorly as mothers (Goodman & Gotlib, 1999). Studies have shown that children of depressed mothers have similar cognitive styles and negative self-concepts (Garber & Robinson, 1997; Nolen-Hoeksema, Girgus, & Seligman, 1992); and that these styles may be somewhat dormant under positive conditions, but can be "turned on" by exposure to situations that raise negative emotions (Taylor & Ingram, 1999). Thus, depressed parents may be modeling cognitive styles that increase their child's vulnerability to depression.

Unfortunately, there has been no investigation of strengths among parents with mental illness, nor of the potential relationship of these strengths to child outcomes. As noted above, however, parents with a mental illness identify parenting as an important and valued role in their lives, and reflect the same desire as non-ill adults, to be the best parents possible (Mallen, 1999; Mowbray et al., 1995b; Nicholson et al., 1998a).

The quality of a marital or partner relationship has been shown to be a strong mediator of the relationship between parental diagnosis and child outcomes (Goodman & Gotlib, 1999; Weintraub, 1987). Although research has focused on marital discord as a negative mediator, some recent work indicates that supportive partnerships may contribute to resilient outcomes in children (Oyserman et al., 2000). This phenomenon will be discussed further in the following section on moderators. Marital discord and divorce are more common among families in which a parent has a mental illness, and adversely affect both the ill parent and children (Downey & Coyne, 1990; Fendrich, Warner & Weissman, 1990; Weintraub). Marital discord predicts a host of child and adolescent problems, including lower academic performance, poor social skills, and conduct problems (Downey & Coyne; Emery, Weintraub, & Neale, 1982; Fendrich et al.). Investigations attempting to distinguish between the effect of marital discord and depression have found that discord rather than depression may be the stronger predictor of child problems (Caplan, 1989; Emery et al.). Thus, interventions for couples in which one or both parents are depressed may be particularly beneficial for children.

A chaotic home environment, lower family cohesion, increased parent-child discord, and poorer communication are more prevalent among families with a parent with depression or schizophrenia (Fendrich et al., 1990; Warner et al., 1995; Weintraub, 1987). These features of family functioning are, in turn, associated with increased risk for emotional and behavioral problems in children (Davies & Windle, 1997; Warner et al.; Weintraub). In a study comparing different levels of family relationships, Dickstein et al. (1998) found that family-level interactions may be more influenced by the presence of parental mental illness than individual parent-child, or spousal relationships. Thus, risk to children may ensue more from family-level interactions not assessed in prior studies of parent-child relationships. By contrast, parent-child relations may be a relative strength for parents with a mental illness, and a promising avenue for intervention.

Moderators of the Relationship between Parent Mental Illness and Child Outcomes
As described above, moderating variables are factors that do not result from a parent's mental illness, but that can enhance or worsen child outcomes in the context of parental mental illness. Moderators, therefore, may provide particularly fruitful avenues for intervention. As discussed throughout this paper, multiple socio-political factors such as political climate, stigma, and the availability of funding for appropriate programs influence the effects of parental mental illness on children, and the risk for the development of problems among children. Additional moderators of the relationship between parental mental illness and child outcomes include characteristics of the spouse or partner, environmental stressors and supports, child characteristics, and therapeutic intervention.

Spouse or Partner Characteristics. The presence and availability of a supportive spouse or partner has been shown to enhance outcomes for both children and adults in a family in which a parent has a mental illness (Musick, Stott, Spencer, Goldman & Cohler, 1987; Puckering, 1989; Tannenbaum & Forehand, 1994; Webster, 1992). In contrast, mental illness and/or substance abuse in the spouse or partner can increase the negative impact of parental mental illness on children both directly, and indirectly, by contributing to increased stress and poorer family functioning (Downey & Coyne, 1990; Warner et al., 1995).

Environmental Stressors. Chronic and/or acute stressors outside the family can also moderate the impact of parental mental illness on children. More specifically, the stress associated with minority status, low levels of education, single parenthood, social isolation and poverty increases the likelihood of emotional and behavioral problems in children of parents with mental illness (Beidel & Turner, 1997; Hammen et al., 1987; Harnish et al., 1995; Sameroff & Seifer, 1983). Moreover, in families with a parent with depression where stress was low, support high, and depressive symptoms less severe, significantly fewer children exhibited mental health problems than children from all families with a parent with depression (10% v. 25%; Billings & Moos, 1983).

Child Characteristics. Initial exploration of the relationship between parental mental illness and child outcomes presumed unidirectional influence, i.e., parental illness affects children. More recent work is revealing that effects may be bidirectional and transactional, with children's characteristics influencing parents' symptoms and behaviors which, in turn, affect children's behavior and functioning (Goodman & Gotlib, 1999; Hammen, Burge, & Adrian, 1991). For example, problematic child behavior creates stress for parents that can exacerbate parents' symptoms and/or can elicit poor parenting practices that, in turn, increase child conduct problems (Cox, Puckering, Pound, & Mills, 1987; Hammen, Burge, & Stansbury, 1990; Keitner & Miller, 1990).

Child characteristics such as temperament, intelligence, social skills, and cognitive processes have been shown to be important sources of risk and resilience for children. Greater intelligence, and strong interpersonal skills (Beardslee & Podorefsky, 1988; Radke-Yarrow & Sherman, 1990) appear to protect children in both the short and long-term from adverse outcomes. Cognitive characteristics such as a positive and coherent self-concept, a positive attribution-style, and effective coping and problem-solving abilities have been associated with good outcomes among children in general and among children with depressed mothers in particular (Beardslee & Podorefsky; Downey & Walker, 1989; Radke-Yarrow et al., 1995)

Child gender also appears to be an important and potentially complex moderating factor in the relationship of parental mental illness and child outcome. Some studies have shown that girls are more adversely affected than boys by a parent's depression (Davies & Windle, 1997; Hops, 1996), while other studies have shown that boys fare worse (Gross, Conrad, Fogg, Willis, & Garvey, 1995). Studies also show that girls and boys may show divergent responses, with girls more likely to develop depression, and boys more likely to show conduct problems (Cummings & Davies, 1994). A recent study further indicated that gender may interact with family functioning such that poor family functioning secondary to maternal depression predicts conduct problems in girls, but not in boys (Davies & Windle).

The relationship of children's age and exposure to parental mental illness is also unclear. Data indicate that repeated exposure to parental illness and the disruption it can create for children are harmful, events more likely to occur if illness occurs when children are young (Oyserman et al., 2000; Sameroff & Seifer, 1983). This has been supported by a single study that showed worse behavior problems among younger children of parents with depression (Inoff-Germain, Nottelmann & Radke-Yarrow, 1997). However, several studies have failed to find age or developmental effects (Oyserman et al.; Weissman, 1989).

Therapeutic Intervention. An intervention may be targeted to and influence mediating or moderating variables and, therefore, become a moderator in the relationship between parental mental illness and child outcomes. Recent years have seen the development of increasing numbers of programs for parents with mental illness. (See the section on Programs for Parents with Mental Illness and their Families of this paper for a more complete description of programs; Oyserman et al., 1994.) However, little standardized evaluation data exist for these programs with respect to child and/or family outcomes. Two intervention projects have provided some promising results.

The Thresholds Mothers' Project in Chicago is a comprehensive services program for mothers with serious mental illness and their young children (aged 0 to 5 years) (Musick et al., 1987). Mothers receive mental health services, parenting education and support. Children and parents attend a therapeutic nursery staffed by child development specialists who work with the children and "coach" the mothers in child development and appropriate play. A five-year study of The Thresholds Mothers Project (Musick et al.) indicated that both mothers and children showed improvement over time. Children evidenced increases in Developmental Intelligence, Intelligence Quotient, social competence and adaptive skills. Mothers' showed enhanced attentional skills, social adjustment, and adjustment to work and parenting roles (Musick et al.). No significant differences in child or maternal outcomes were noted for a comparison of Thresholds' participants and participants in a much less comprehensive home-based aftercare program where participants received weekly visits from a psychiatric nurse or social worker (Musick et al.).

In a second intervention program for families coping with parental affective illness, Beardslee and colleagues provided education to parents and children about the parents' illness and the potential effects of parental mental illness on the family. Results showed that families reported improvements across many areas of behavior and attitude consistent with better child outcomes (Beardslee et al. 1997a, 1997c; Beardslee, Wright, Rothberg, Salt, & Versage, 1996b). These changes included improved family and parent-child communication, increased communication between parents and children about depression, and adoption of new family/parenting coping strategies, among others. Children reported better understanding of parental illness, and better adaptive functioning, however some of the children experienced significant symptoms in the period of observation after the intervention (Beardslee et al., 1997c).

SUMMARY: Research on child outcomes has uncovered multiple sources of risk and resilience for children who have parents with mental illness. The majority of studies have focused on white, middle class samples of children of depressed mothers. It is therefore difficult to know whether these same models might be applied more generally across race, class and parental psychiatric diagnoses. In addition, the influence of ethnic and cultural differences is not understood. Within these limitations, studies have revealed that both genetic/biological and environmental factors can be sources of risk and resilience. However, most investigations of resilience have focused on environmental variables. Specifically, studies have revealed that heredity, severity and chronicity of illness, parenting behavior, marital discord, and family relationships are important mediators of the relationship of parental mental illness and child outcomes. Spousal or partner characteristics, environmental stress and support, and child characteristics such as temperament, cognitive styles and interpersonal skills are important moderators. Studies have focused heavily upon sources of risk, and may have missed potentially powerful sources of resilience upon which interventions might be based. Data do not reflect children's subjective experience of parental mental illness, or reports of what children think might be useful. In spite of these limitations, interventions founded upon what is known about sources of risk and resilience have been somewhat fruitful, though few and far between. In particular, efforts to enhance children's understanding of mental illness and parents' understanding of children's needs have shown promising results.

RECOMMENDATIONS: Increased research attention must be paid to strengths and sources of resilience among both parents and children; and to how sources of both risk and resilience relate to ethic and cultural differences. Children must be asked about their experiences of living with parents with mental illness, and their needs. Effort should be made to bridge the gap between research and practice. Current knowledge about sources of risk and resilience should be translated into practical interventions that enhance sources of resilience and mitigate sources of risk. These interventions should be evaluated for effectiveness.