Predictors of relationship functioning for patients with bipolar disorder and their partners.

Abstract

Previous investigations have examined family functioning, including marital functioning, as an important predictor of the course of bipolar disorder, but limited research exists identifying the factors that influence relationship functioning in patients with bipolar disorder. In the current study, 56 patients with bipolar disorder and their partners were assessed for Axis II pathology, general family functioning, and relationship distress. Patient mood symptoms and Axis II pathology variables were examined as predictors of general relationship functioning (Family Assessment Device, McMaster Clinical Rating Scale, and Dyadic Adjustment Scale) in regression models. Analyses indicated that patients' depressive symptomatology was associated with patient ratings of general family functioning and couple functioning, while patients' manic symptoms were associated with partners' ratings of the romantic relationship. Partners' total Axis II pathology, but not patients' Axis II pathology, was associated with patient and partner perception of the couple's relationship. These findings highlight the importance of mood and personality pathology to relationship functioning, and represent one of the first investigations to verify the impact of personality pathology on patients' and partners' perceptions of relationship functioning.

The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations

“…Among personality measures, FAD scores were associated with neuroticism (Miller et al., ) and conscientiousness (Miller et al., ) in depressed patients. In several psychiatric samples, FAD pathological scores also showed a relation with comorbidity with personality disorders (Miller et al., ), mania (Uebelacker et al., ), symptom severity and frequency (Evans, McHugh, Hopwood, & Watts, ; Febres, Rossi, Gaudiano, & Miller, ; Liepman et al., ; Sheets & Miller, ; Waller, ), and lower psychosocial functioning (Guada, Hoe, Floyd, Barbour, & Brekke, ). Poorer scores on the FAD also predicted greater physical violence victimization by partner in both male and female suicidal inpatients, even after controlling for alcohol use and demographic characteristics (Heru, Stuart, Rainey, Eyre, & Recupero, ).…”

Correlates of real world executive dysfunction in bipolar I disorder

“…Approximately 50% of patients are unemployed and those who are employed tend to experience diminished work performance (Bowden, 2005). Additionally, many individuals with bipolar disorder do not live independently (Wyatt and Henter, 1995), have unstable relationships (Depp et al, 2010; Kokcu and Kesebir, 2010; Sheets and Miller, 2010), and experience diminished levels of overall life satisfaction (Altamura et al, 2011; Latalova et al, 2011). Thus, understanding features of this illness that cause functional impairment is vital to its treatment as well as improvement in overall level of satisfaction.…”

Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

“…PD pathology was evaluated at this time point based on expert recommendations about minimizing the impact of acute mood symptoms on PD assessment [37] and based on the need to identify a time point by which acute mood symptoms had begun to decrease but which was still relatively close to baseline assessments [38]. Of note, recent evidence suggests that personality pathology can be validly assessed even in the presence of significant affective symptoms [8].…”