Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2014-0003
Trends in Psychiatry and Psychotherapy
Original Article

Dysfunctional family environments and childhood psychopathology: the role of psychiatric comorbidity

Ambientes de famílias disfuncionais e psicopatologia infantil: o papel da comorbidade psiquiátrica

Suzielle M. Flores; Giovanni A. Salum; Gisele G. Manfro

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Abstract

Introduction: The study of the association between specific characteristics of family environments and different types of psychopathology may contribute to our understanding of these complex disorders and ultimately inform therapeutics.Objective: To compare the family characteristics of four groups: typically developing children; children with anxiety disorders only; children with externalizing disorders only; and children with both anxiety and externalizing disorders.Methods: This study enrolled 115 individuals from the community. Child psychiatrists made psychiatric diagnoses using a structured clinical interview. The Family Environment scale was used to evaluate six domains of family function.Results: The group with both anxiety and externalizing disorders had higher levels of conflict in family environment and lower levels of organization when compared with typically developing children. In addition, internalizing and externalizing symptoms were positively associated with conflict and negatively with organization. Maternal depressive and anxious symptoms were also associated with higher conflict and lower organization scores.Conclusion: An important between-group difference in comorbid cases of anxiety and behavioral disorders suggests that children with this comorbidity are potential candidates for family interventions to address family conflicts and organizational aspects.

Keywords

Anxiety, phobias, family, comorbidity, ADHD

Resumo

Introdução: O estudo da relação entre características específicas do ambiente familiar e os diferentes tipos de psicopatologias pode contribuir para o nosso entendimento desses complexos transtornos e possivelmente gerar informações para seu tratamento.Objetivo: Comparar as características familiares de quatro grupos: Crianças com desenvolvimento típico; crianças com transtornos de ansiedade apenas; crianças com transtornos de externalização apenas; e crianças com transtornos de ansiedade e de externalização.Métodos: Cento e quinze indivíduos foram recrutados na comunidade. Psiquiatras pediátricos usaram uma entrevista clínica estruturada para estabelecer os diagnósticos psiquiátricos. A Escala do Ambiente Familiar (Family Environment) foi usada para avaliar os seis domínios de funcionamento da família.Resultados: O grupo que apresentava tanto transtornos de ansiedade quanto de externalização apresentou níveis mais altos de conflito e níveis mais baixos de organização quando comparados com as crianças com desenvolvimento típico. Além disso, os sintomas de externalização e internalização estavam positivamente relacionados a conflitos e negativamente a organização. Sintomas depressivos e de ansiedade da mãe também se mostraram relacionados a resultados mais altos para conflito e mais baixos para organização.Conclusão: Uma importante diferença entre grupos em casos de comorbidades de transtornos de ansiedade e de comportamento sugerem que as crianças com esta comorbidades são candidatos em potencial para intervenções familiares que abordem conflitos familiares e aspectos organizacionais.

Palavras-chave

Ansiedade, fobias, família, comorbidade, TDAH

References

Vianna VP, Silva EA, Souza-Formigoni ML. [Portuguese version of the Family Environment Scale: application and validation]. Rev Saude Publica. 2007;41:419-26.

Rutter M, Cox A, Tupling C, Berger M, Yule W. Attainment and adjustment in two geographical areas. I--The prevalence of psychiatric disorder. Br J Psychiatry. 1975;126:493-509.

Pressman LJ, Loo SK, Carpenter EM, Asarnow JR, Lynn D, McCracken JT. Relationship of family environment and parental psychiatric diagnosis to impairment in ADHD. J Am Acad Child Adolesc Psychiatry. 2006;45:346-54.

Pheula GF, Rohde LA, Schmitz M. Are family variables associated with ADHD, inattentive type? A case-control study in schools. Eur Child Adolesc Psychiatry. 2011;20:137-45.

Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, Mick E. Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter's indicators of adversity. Arch Gen Psychiatry. 1995;52:464-70.

Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, Mick E. Impact of adversity on functioning and comorbidity in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1995;34:1495-503.

Ogburn KM, Sanches M, Williamson DE, Caetano SC, Olvera RL, Pliszka S. Family environment and pediatric major depressive disorder. Psychopathology. 2010;43:312-8.

Kepley HO, Ostrander R. Family characteristics of anxious ADHD children: preliminary results. J Atten Disord. 2007;10:317-23.

Salum GA, Isolan LR, Bosa VL, Tocchetto AG, Teche SP, Schuch I. The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings. Rev Bras Psiquiatr. 2011;33:181-95.

Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry. 1999;38:1230-6.

Isolan L, Salum GA, Osowski AT, Amaro E, Manfro GG. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents. J Anxiety Disord. 2011;25:741-8.

Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980-8.

Klein RG. Anxiety disorders. J Child Psychol Psychiatry. 2009;50:153-62.

Hughes AA, Hedtke KA, Kendall PC. Family functioning in families of children with anxiety disorders. J Fam Psychol. 2008;22:325-8.

Polanczyk GV. Searching for the developmental origins of mental disorders. Rev Psiquiatr Rio Gd Sul. 2009;31:6-12.

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