Although there are contestations regarding the contributing or causal factors of bipolar disorder, consensus shows that genes, brain structure and anxiety are the main causes or aggravating factors of the bipolar disorder (Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005). The genetic argument is based on the idea that the condition is caused by genetic structure.
Thus, children of parents with the disorder are at an increased risk of developing it. Abnormal brain structure follows that improper brain functioning facilitates the development of the health complications. As for the anxiety disorders, reference is made to the idea that the presence of other disorders that emanate from elevated expectations lead to the emergence of the disorder. However, the causes of the bipolar disorder are far from being clear. The main symptoms include: exaggerated happiness or sadness, short temper, ranting, sleeping problems, and lack of focus among others (Kessler et al., 2005). The current paper explores learning problems among children (between the ages of 0 and 5) of bipolar parents.
Kessler et al. (2005) defined bipolar disorder (manic-depressive illness) as a neurobiological disorder that affects around six million Americans largely aged eighteen and older. Based on the figure, it is approximated that 2.6% of the adult population suffers from this condition. Victims of the condition are characterized by mood swings that alternate from time to time (Kessler et al., 2005). Extremes of the condition are known as mania (severe high) and depression (extreme low). Thus, the disorder is characterized by the dramatic mood shifts which are related to the variations in the levels of energy.
Children are expected to develop normally in order to become responsible adults later in life. However, growing up in a family having individuals suffering from the bipolar disorder might deny them an opportunity to develop normally. The problem is further complicated when victims of the condition do not receive medical care. Kessler et al. (2005) indicated that up to 51% of those affected by the disorder did not receive treatment. In addition, victims suffer from many other complications resulting from the condition. However, Kessler et al. (2005) observed that suicide was the leading cause of death among individuals suffering from bipolar disorder. In particular, Kessler et al. (2005) claim that between fifteen and seventeen percent of the victims committed suicide because of the negative symptoms resulting from the symptoms being untreated.
Citing a United Kingdom national survey, Reupert, Maybery, and Kowalenko (2012) indicate that 10% of women and 6% of men suffering from mental illnesses were parents. Reupert et al. (2012) also cite a report by the Central Coast Mental Health Service in New South Wales which showed that 28% of parents had mental problems. The same authors indicate that according to the Australian Bureau of Statistics 24% of Australian children came from families with caregivers suffering from mental illnesses. In addition, a Mental Health Branch across Victoria in 2005 demonstrated that 20.4% of patients with mental disorders were parents. The implication from the above statistics is that one out of five children lives in a family where one of the parents has a mental disorder. Such statistics draws a grim picture as it pertains to child upbringing due to the role parents play in the development of children. The following graph is used to capture some critical data pertaining to the bipolar disorder.
The disorder has a number of effects on victims as well as those who live with them. Wals et al. (2006) conducted a study in a bid to predict changes in the behavior among children of bipolar disorder parents. Based on their study, children of such parents were at a high risk of DSM-IV mood alongside other non-mood disorders. However, the relationship was not linked to the genetics that was assessed based on familial loading from substance abuse, bipolar disorder, and psychopathology. The study also showed that families with a bipolar parent were different from the average ones in terms of cohesion, organization and emergence of conflicts. Based on the findings, Wals et al. (2006) proposed to identify the risk factors early to ensure the prevention of the development of chronic and severe problems among children of bipolar parents. The above findings support the idea that children, especially those aged below the age of five largely suffer when being taken care of by parents with disorders.
If to consider the treatment implications of emotion regulation among children of bipolar parents, it should be noted that Muralidharan, Yoo, Ritschel, Simeonova, and Craighead (2010) observed that being a child of a parent suffering from a mental disorder was a risk factor both psychologically and genetically. The author also indicated that reviewing child-parent interaction patterns would be helpful in designing useful interventions to cure victims. Based on the above findings, children are likely to suffer both physically and genetically. In this regard, it is discerned that their learning or nurturing is also affected negatively.
Muralidharan et al. (2010) also conducted a comprehensive study aimed at documenting the development of emotional regulation among children with bipolar parents. Focusing on familial and socio-economic risk factors, Muralidharan et al. (2010) observed that bipolar parents’ offspring were at an increased risk of developing psychopathology. Socio-emotional cue processing deficits that involve erroneous detection of face social cues and family environmental variables (high degree of family conflict coupled with dysfunctional parenting) are among the outcomes of the disorder. Furthermore, Muralidharan et al. (2010) observed that the disruption effect of the development of the emotion regulation system was potentially a mediating factor in the onset of psychopathology among children. As a result, there should be considered factors influencing the development of emotion deregulation and contributory factors to the expression of emotions.
Based on the literature review, Muralidharan et al. (2010) found that deregulation in bipolar disorder resulted from the dysfunction in the interactive brain network which comprises temporal medial regions (hippocampus and amygdala), prefrontal regions, and subcortical regions (thalamus and striatum). Both the amygdala and striatum play an important role in the processing of reward and emotional stimuli. The two are also connected to the prefrontal region which is in charge of executive functioning, attention, reward-oriented decision making and control of emotion. For a young child, being rewarded and reprimanded is integral for their development. However, in the event that parents have problems with reward and emotional stimuli, there are certain issues that undermine the nurturing of the child in question.
According to Muralidharan et al. (2010), emotional deregulation in patients suffering from bipolar disorder results from impaired inhibitory response from the prefrontal cortical structure to subcortical and temporal medial ones. Children of parents suffering from the disorder are thus exposed to the environmental risk of developing a disorder at a tender age. Given that children are undergoing major changes, such conditions hinder their development. As Muralidharan et al. (2010) demonstrates, neural development is sensitive to environmental stressors at this age. Thus, socio-emotional cue processing deficit and familial stress are some of the concerns that children of bipolar disorder parents encounter.
Furthermore, Muralidharan et al. (2010) observes that various approaches have been explored in a bid to address the problem. Among them is the withdrawal strategy which proves to be ineffective especially when emotional homeostasis and parental effect on emotional states are involved. Considering that parental responses influence infants’ display of emotions, bipolar disorder parents have a limited chance of guiding their children effectively. According to Becker-Weidman and Shell (2005), unresponsive or insensitive parenting plays a role in the development of insecure attachment. Insecurely attached children (infants and toddlers) have troubles with controlling their emotions in disturbing situations.
Infants from troubled upbringing are unable to employ strategies such as distress control to influence their own state unlike those from normal environment (Becker-Weidman & Shell, 2005). In one year, infants learn how to control and regulate distress (Becker-Weidman & Shell, 2005). Failure to exercise control demonstrates that the prefrontal cortical region may have been basically decoupled from the areas involved in the process (Muralidharan et al., 2010). Infants rely on caregivers for emotional support which helps them to respond to disturbing situations through the process of social referencing. However, children of disorderly parents suffer from negativity in emotional attachment as the guardians/parents are incapable of sound nurturing.
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Within a clinical context, attachment theory demonstrates that disorders emerge as a result of a failure in the development of the normal attachment between children and caregivers at the early age (Becker-Weidman & Shell, 2005). In such an event, children whose parents suffer from bipolar disorder are likely to experience lifelong problems. In order to solve such problems, exploration of the use of therapeutic approaches is often advised. Among some of the most reputable frameworks are the Dyadic Developmental Psychotherapy and Theraplay (Becker-Weidman & Shell, 2005). The two therapeutic approaches are applied to treat the disorder. The Dyadic Developmental Psychotherapy is an evidence-based therapy that targets children who experience neglect, loss, pervasive extensive trauma and other deregulating experiences (Becker-Weidman & Shell, 2005). The treatment method draws from the principles of the attachment theory. The Theraplay therapy is also applicable to the treatment of the disorders that result from poorly developed attachment (Becker-Weidman & Shell, 2005). The approach relies on attachment-oriented game to achieve the established objectives. In addition, the treatment method is based on the attachment and interactions that characterize healthy parent-infant relationships.
As for the medication intervention, antidepressants and serotonin inhibitors are used (Reupert et al., 2013). The treatment consists in lowering the levels of depression or manic excitement among patients (Reupert et al., 2013). According to the authors, mood stabilizers, anticonvulsant or antipsychotic drugs can also be used to manage the condition. The use of any of the drugs should be carried out based on the assessment of the patient in question given that their effectiveness varies depending on one’s state. In addition, attempts to improve family stability are a major intervention aimed at helping parents suffering from the bipolar disorder (Reupert et al., 2013). The approach is useful when it is determined that the family conditions cause the development of an illness. In this regard, proposing that the affected person undertakes activities different from routine engagements would be ideal. In addition, teaching the affected person as for the ways of handling family tension and conflicts is also helpful.
Attachment theory is sometimes regarded as a group of theories focusing on psychological tendencies to pursue intimacy among persons. The feeling of security in the presence of a person and a feeling of anxiousness in an individual’s absence can be understood with the help of the theory. According to Becker-Weidman and Shell (2005), the theory has its origins in experiments carried out on animals. Based on a series of experiments conducted by Harrow and Harrow on monkeys, it emerged that attachment is more complex than a single reaction resulting from internal triggers such as hunger (Becker-Weidman & Shell, 2005). In the initial experiment, the researchers found out that monkeys brought up in disturbing environments demonstrated erratic and abusive behavior towards the younger ones. Similarly, infants brought up in neglect conditions also grew into uncaring and abusive mothers. The abnormal behavior shows that a bond between mother and offspring influences their social development.
The basic attachment theory is critical for the understanding of the connection between a parent and child. Children develop dissimilar styles of attachment based on interactions and experiences with their caregivers. Based on this position, Becker-Weidman and Shell (2005) proposed four attachment styles to understand the connection between a parent and child during the process of development. These include: disorganized, secure, anxious-ambivalent, and anxious-avoidant styles.
Within a clinical context, attachment theory demonstrates that disorders emerge as a result of a failure in the development of the normal attachment between children and caregivers at an early age (Becker-Weidman & Shell, 2005). In such an event, victimized children are likely to experience lifelong problems. In order to solve the problems, the use of therapeutic approaches is often recommended. Among some of the most reputable frameworks as indicated earlier are the Dyadic Developmental Psychotherapy and Theraplay. Some of the disorders that emanate from poor upbringing include: Reactive Attachment Disorder which is a psychiatric condition (DSM-IV) involving disturbing and developmentally unsuitable social associations in many contexts starting early before the age of five (Wals et al., 2006). The disorder is largely associated with grossly pathological care.
The attachment theory fundamentally differs from the Freudian one. In particular, the attachment theory proposes making children never break away from previous attachments as suggested by the Freudian version (Becker-Weidman & Shell, 2005). On the contrary, the attachment theory argues that children add new attachments to the existing ones instead of erasing or substituting the previous ones.
Regarding secure attachment, the theory portends that a child who attaches with the mother securely will exercise the freedom to engage people in public and demonstrate different emotions when the mother goes away and comes back (Becker-Weidman & Shell, 2005). Securely attached children explore new environments because they believe that the presence of their caregivers guarantees protection. Such children also believe that in case of an emergency, they will get support from their parents. Such emotional connection or attachment is beneficial for the development of a child as it helps the young children to handle situations in the future. The above style demonstrates the essence of having a sound mother or father to take care of the needs of a growing child. Based on the findings, it is held that it is highly unlikely that a parent suffering from bipolar disorder will perform his/her parenting role effectively. Because of the irregular mood swings, such a parent would fail to provide a young child with the necessary reassurances needed for appropriate growth and development.
As for the anxious-ambivalent insecure attachment cases, reference is made to children who feel anxious when encountering strangers despite the presence of caregivers (Becker-Weidman & Shell, 2005). In such instances, the departure of a parent leaves the children in a condition of distress. Upon the return of the parent, the child will demonstrate ambivalence by seeking to remain closer despite showing disdain for the parent. The development of such kind of attachment shows that the guardian engages the child only on her own terms resulting in resentment of the relationship. The ignorance of children’s needs is the primary contributor to the developing association. The assessment of the bipolar disorder depicts that victims fall into two extremities (low or high). Accordingly, there are instances when parents are responsive, and when they are disinterested. As a result, it is held that this reflects the style of parenting of a person with bipolar disorder.
Anxious-avoidant insecure attachment is another dominant style of attachment. According to the model, a child avoids or ignores the mother showing no emotional connection between them (Becker-Weidman & Shell, 2005). As such, the child does not explore many issues regardless of the person who is at the scene. The child is indifferent when encountering strangers or the mother. Similarly, whether the place is deserted or not, the child is not affected. Hence, the child is disengaged with the mother/parent. Such behavior shows that the needs of the child are never met; hence the need for communication is absent. Based on the assessment of the bipolar disorder, victims fall into two strands (low or high). As a result, there are instances when the parents are willing to be good to the child while in other instances, they prefer being disinterested. As a result, it is held that the style does not reflect the peculiarities of parenting of a person with bipolar disorder.
The final category depicting disorganized attachment shows the absence of coherence in patterns of coping with problems (Becker-Weidman & Shell, 2005). Whereas the former two styles (avoidant and ambivalent) are not effective, they provide sound strategies in terms of facing the world. For children with disorganized attachment, their interactions and experiences are based on fear. If the relationship between a child and parent is based on erratic responses, then the above attachment takes different forms. The latter category of attachment best describes the parenting outcome of a person with bipolar disorder. Given the irregularity of mood swings, parenting victims are likely to confuse their children due to the inconsistencies that would emerge from their interaction. As a result, the child is left to guess about what to expect.
The social learning theory which argues that behavior is acquired based on their observations of the environmental was initially developed by Albert Bandura. Taking a different perspective from the one taken by Skinner, Bandura based his theory on the belief that humans actively process information (Miller, 2011). Additionally, human beings review their relationships on the basis of behavior and consequences. However, for observational learning to take place, the cognitive process has to be operational.
Children are known to be engaged in a learning process almost all the time. As a result, it is suggested that children examine people around them in different ways. The persons who the children observe are viewed as models. Across societies, individuals are surrounded by a number of models including parents, TV characters, peers and school teachers. Such models provide behavior examples which children observe and try to imitate. Masculinity, feminism, pro-social or antisocial behaviors are some of the traits that children strive to acquire. By paying attention to what happens around in the environment, children are able to encode the behavior. Later, they imitate what they have observed. Speaking about children, they copy a form of conduct regardless of it being gender-specific. However, many processes influence the reproduction of behavior to fit societal expectations regarding appropriateness based on one’s sex. Given that a child is constantly involved in the learning process, chances of encountering inconsistent behavior remains high when a parent/caregiver suffers from bipolar disorder. Based on the understanding of the disorder, patients exhibit variations in their behaviors. Given that children are in the process of learning, they are likely to be confused since parents with the disorder are likely to fail to show leadership or consistency when handling their children.
In practice, children are interested in replicating the behavior of persons/characters, they deem similar to them. Thus, the likelihood of imitating people of the same sex remains high compared to copying those of the opposite sex. In response, people around children either reinforce or discourage the behavior through rewards or punishments (Miller, 2011). When the aped behavior is deemed positive, it is rewarded resulting in its reinforcement. However, if the behavior is viewed as negative, it is punished resulting in its discouragement. Thus, depending on the response of the guardians, children extend or cease behaviors. When rewarded, a child will carry on the conduct but will stop it if punished. Based on the above point, children are interested in replicating the behavior of their significant others. In the absence of uniform behavior, children will be left confused about what to do. The confusion is likely to be reflected in the behavior of children.
Reinforcement of behavior also varies from being external to internal or from being positive to negative (Miller, 2011). When a child is inspired by other people such as parents, external reinforcement is expected. However, the feeling of contentment as a result of a positive remark resulting in internal reinforcement also takes place. Given that children wish to be approved, they are likely to behave in a manner that yields the parents’ approval. However, dealing with a bipolar parent would be difficult due to the possibility of encountering mixed behaviors. Positive or negative forms of reinforcement have minimal impact when the reinforcement presented externally fails to match the needs of the individuals involved (Miller, 2011). Whether positive or negative, the important element about reinforcement is to result in the desired change in a person/child’s behavior. In practice, children also take into consideration what happens to those around before deciding what to imitate. Famously known as vicarious reinforcement, the aspect is critical in the assessment of the parenting and behavioral adoption. It is interested that the attachment is developed to given models because they possess rewarding qualities. In practice, children have many models with whom they coalesce around. Such people are parents, fantastic characters or siblings. The urge to identify with a model rests on the possession of a trait that a child aspires to have. Based on the above information, reinforcement has minimal effect when it fails to match the needs of the individuals involved. Unfortunately, parents with the bipolar disorder are certain to display such behavior whenever they encounter mood swings. As a result, children are likely to suffer adversely when being brought up by affected caregivers.
The identification process takes place through the adoption of values, attitudes, beliefs and behaviors of the model person (Miller, 2011). Through the process, the child internalizes or adopts another individual’s way of conduct. Identification differs from imitation because it involves adoption of numerous behaviors whereas the latter is about aping one given trait. Children between the age of 1 and 5 are likely to be confused because of the inconsistent behavior demonstrated by their parents who suffer from the bipolar disorder.
Depressed parents are a source of instability in families (Kessler et al., 2005). If one partner suffers from a mania or depression, the other partner is likely to be affected negatively. In the absence of treatment or counseling of both marriage partners, the condition is likely to lead to further strain within the family. In such melee, children are not developed normally. In single-parent families, the family situation always results in an unfamiliar scenario that does not support a healthy development of children. If a parent who does not suffer from bipolar disorder, the possibility of dysfunctionalism is high given that he/she must play both father’s and mother’s roles. For instance, a single father is supposed to be a provider as well as care-taker. Any parent in such a situation must work harder than the average person. In some instances, the single parent is penetrated with frustration and a feeling of helplessness thus creating an unsupportive environment. As already mentioned, parents suffering from the bipolar disorder are at a greater disadvantage because they are likely to let their mood swings interfere with their parenting thus undermining the development of their children.
The environment is a major factor in the development of children. In case of the bipolar disorder parents, their offspring are at a precarious situation primarily because of their erratic behavioral patterns. The current paper established that parental psychopathology has a significant impact on the general development of their children. It also emerges that children of parents with the bipolar disorder develop disordered functioning as suggested by both the attachment and social learning theories. The disorganized upbringing because of parents with the disorder hinders the functioning of various domains in children. In particular, aggression is among the most frequently displayed parenting behaviors which are unsupportive of the development of the child. Depressed individuals possess a more negative thinking than the average people. Given that children rely on their primary caregivers for support, there is likelihood that the negativity will be transferred to the growing children. It is also noted that the exposure of infants to harsh and unpredictable surroundings has lasting ramifications on their development. Other concerns are related to cohesion and organization which are often lacking among parents with the disorder. In the absence of the core attributes of parenting, infants are adversely influenced early in life. Based on the findings, it can also be concluded that psychosocial functioning also results from growing up in an unpredictable environment.
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