Coping strategies and self-esteem in the high-risk offspring of bipolar parents

Aust N Z J Psychiatry. 2019 Feb;53(2):129-135. doi: 10.1177/0004867418761577. Epub 2018 Mar 14.


Objectives: This study investigated whether there were differences in coping strategies and self-esteem between offspring of parents with bipolar disorder (high-risk) and offspring of unaffected parents (control), and whether these psychological factors predicted the onset and recurrence of mood episodes.

Methods: High-risk and control offspring were followed longitudinally as part of the Flourish Canadian high-risk bipolar offspring cohort study. Offspring were clinically assessed annually by a psychiatrist using semi-structured interviews and completed a measure of coping strategies and self-esteem.

Results: In high-risk offspring, avoidant coping strategies significantly increased the hazard of a new onset Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised mood episode or recurrence (hazard ratio: 1.89, p = 0.04), while higher self-esteem significantly decreased this hazard (hazard ratio: 2.50, p < 0.01). Self-esteem and avoidant coping significantly interacted with one another ( p < 0.05), where the risk of a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised new onset mood episode or recurrence was only significantly increased among high-risk offspring with both high avoidant coping and low self-esteem.

Conclusion: A reduction of avoidant coping strategies in response to stress and improvement of self-esteem may be useful intervention targets for preventing the new onset or recurrence of a clinically significant mood disorder among individuals at high familial risk.

Keywords: High risk; coping; longitudinal; mood disorders; risk factors; self-esteem.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Bipolar Disorder
  • Canada / epidemiology
  • Case-Control Studies
  • Child of Impaired Parents / psychology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mood Disorders / epidemiology*
  • Self Concept*
  • Young Adult