Personality of parents with bipolar disorder and interpersonal functioning among their offspring: a prospective 10-year study.

Abstract

A comparison of offspring of parents with bipolar disorder (OBD) and offspring of parents with no mental disorder (ONMD) showed that parents' neuroticism was associated with internalizing and externalizing problems among their children. The present study examined whether parents' neuroticism predicted poor interpersonal functioning among offspring 10 years later and whether the problems observed in middle childhood mediated the association between parents' neuroticism and offspring functioning. When offspring were in middle childhood, parents completed the revised NEO Personality Inventory and rated the child's behavior on the Child Behavior Checklist. Ten years later, 65 OBD and 59 ONMD completed interviews assessing mental disorders and interpersonal and noninterpersonal functioning. High neuroticism and low agreeableness in parents predicted poor interpersonal functioning in their offspring in late adolescence-early adulthood. The offspring's externalizing and internalizing problems in middle childhood partially mediated the association between parents' personality and offspring interpersonal functioning. Moreover, the association between parents' neuroticism and offspring internalizing problems was stronger among the OBD than the ONMD. Overall, the results suggested an intergenerational transmission of risk whereby high neuroticism and low agreeableness in parents were associated with behavioral problems among offspring in middle childhood that, in turn, predicted poor interpersonal functioning 10 years later.

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REGULAR ARTICLE
Personality of parents with bipolar disorder and interpersonal
functioning among their offspring: A prospective 10-year study
CAROLINE S. OSTIGUY,aMARK A. ELLENBOGEN,aAND SHEILAGH HODGINSb
aConcordia University; andbKing’s College London, Heidelberg University, and Universite ´ de Montre ´al
Abstract
Acomparisonofoffspringofparentswithbipolardisorder(OBD)andoffspringofparentswithnomentaldisorder(ONMD)showedthatparents’neuroticism
was associated with internalizing and externalizing problems among their children. The present study examined whether parents’ neuroticism predicted
poor interpersonal functioning among offspring 10 years later and whether the problems observed in middle childhood mediated the association between
parents’neuroticismandoffspringfunctioning.Whenoffspringwere inmiddlechildhood,parentscompletedtherevisedNEOPersonalityInventoryandrated
the child’s behavior on the Child Behavior Checklist. Ten years later, 65 OBD and 59 ONMD completed interviews assessing mental disorders and
interpersonal and noninterpersonal functioning. High neuroticism and lowagreeableness in parents predicted poor interpersonal functioning in theiroffspring
in late adolescence–early adulthood. The offspring’s externalizing and internalizing problems in middle childhood partially mediated the association
between parents’ personality and offspring interpersonal functioning. Moreover, the association between parents’ neuroticism and offspring internalizing
problemswasstrongeramongtheOBDthantheONMD.Overall,theresultssuggestedanintergenerationaltransmissionofriskwherebyhighneuroticismand
low agreeableness in parents were associated with behavioral problems among offspring in middle childhood that, in turn, predicted poor interpersonal
functioning 10 years later.
Early in development, the negative consequences of having
a parent with an affective disorder can be detected among
theiroffspring.Forexample,childrenofmotherswithdepres-
sion exhibit more negative affect, less positive affect, fewer
vocalizations, less motor activity, less secure attachment,
lower social competence, more internalizing and externaliz-
ing behaviors, and abnormal brain asymmetry compared to
children of healthy mothers (Field, 2002; Jones, Field, Fox,
Lundy, & Davalos, 1997; Murray, Fiori-Cowley, Hooper, &
Cooper, 1996; Radke-Yarrow, Nottelmann, Martinez, & Fox,
1992). Through middle childhood and adolescence, the off-
springofmotherswithdepressioncontinuetoexhibitelevated
ratesofinternalizingandexternalizingproblems(Elgar,Mills,
McGrath, Waschbusch, & Brownridge, 2007), abnormalities
in emotional information processing (Joormann, Talbot, &
Gotlib, 2007), and elevated hypothalamic–pituitary–adrenal
(HPA)functioninginthenaturalenvironment (Halligan,Her-
bert,Goodyer,&Murray,2004).Lessisknownabouttheoff-
spring of parents with bipolar disorder (OBD) in childhood
(LaRoche, 1985), with one study suggesting lower rates of
problem behaviors among OBD than among the offspring of
parentswithdepression(Anderson&Hammen,1993).Studies
have shown that OBD, compared to offspring of healthy par-
ents, experience higher levels of episodic and chronic stress
(Ostiguyetal.,2009),performpoorlyontestsofexecutivefunc-
tion (Klimes-Dougan, Ronsaville, Wiggs, & Martinez, 2006),
exhibit attentional biases to emotional information (Gotlib,
Traill, Montoya, Joormann, & Chang, 2005), and show al-
terations in the functioning of the stress-sensitive HPA axis
(Ellenbogen, Hodgins, Walker, Couture, & Adam, 2006; El-
lenbogen, Santo, Linnen, Walker, & Hodgins, 2010). Al-
though these features distinguished OBD from offspring of
parents with no mental disorder (ONMD) in cross-sectional
studies,littleisknownaboutfactorsandmechanismsoperating
intheearlylifeoftheOBDthatcontributetotheirvulnerability
for mood disorders later in life.
Neuroticismisapersonalitytraitcharacterizedbyapropen-
sity to experience negative emotions such as anger, sadness,
guilt, and irritability (Costa & McCrae, 1992a). Individuals
high in neuroticism struggle with interpersonal and occupa-
tional problems, generate stressful life events,anduseineffec-
tive coping strategies (Belsky & Barends, 2002; DeLongis &
Holtzman, 2005; Ellenbogen & Hodgins, 2004; Watson,
Address correspondence and reprint requests to: Mark A. Ellenbogen,
Concordia University, Department of Psychology, 7141 Sherbrooke West,
Montre ´al, QC H4B 1R6, Canada; E-mail: mark.ellenbogen@concordia.ca.
ThisresearchwassupportedbyagrantfromtheCanadianInstitutesofHealth
Research (to M.A.E.). Mark A. Ellenbogen is currently supported by a Ca-
nada Research Chair appointment from the Social Sciences and Humanities
Research Council of Canada. Caroline Ostiguy was supported by a scholar-
ship from the Fonds du Que ´bec en Recherche sur la Socie ´te ´ et la Culture. We
thank Sophie Cote ´ and Leandra Hallis for their invaluable assistance on this
projectandallofthefamiliesforsograciouslytakingthetimetoparticipatein
our research.
Development and Psychopathology 24 (2012), 573–587
#Cambridge University Press 2012
doi:10.1017/S095457941200017X
573
Development and Psychopathology, 2012, 24(2), 573-587,
doi: 10.1017/S095457941200017X

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Gamez, & Simms, 2005). The trait of neuroticism, like other
personality traits, affects parenting practices, and may thereby
impact offspring functioning, as initially proposed by Belsky
(1984) and subsequently supported by empirical findings
(Prinzie, Stams, Dekovic, Reijntjes, & Belsky, 2009). For ex-
ample, parents high in neuroticism displayed lower levels of
smiling, talking, and touching with their infant than parents
low on neuroticism (Zaslow, 1985). Similarly, mothers high
in neuroticism exhibited a parenting style that was less warm,
lessresponsive,andmoreintrusivethanmotherslowinneurot-
icism(Belsky,Crnic, &Woodworth,1995;Clark,Kochanska,
& Ready, 2000; Kochanska, Clark, & Goldman, 1997). High
maternal neuroticism, assessed by self-report or observation,
hasbeenassociatedwithdefiance,anger,behavioralproblems,
and insecure attachment among offspring in early childhood
(Kochanska et al., 1997). Moreover, adolescent and adult off-
spring of parents high, compared to those low in neuroticism,
were found to have an increased sensitivity to stressful life
events, poorer mental health, more antisocial behaviors, and
morepersonaladjustmentproblems(Conger,Conger,Elder,&
Lorenz,1992;Elder,Caspi,&Downey,1986;VanOs&Jones,
1999). Thus, evidence shows that high levels of neuroticism
among parents are associated with nonoptimal parenting prac-
tices and a broad range of negative outcomes among their off-
spring from early childhood to early adulthood.
We have previously postulated a model to explain the
association between parents’ personality and vulnerability
to psychopathology among offspring of parents with bipolar
disorder (BD; Ellenbogen & Hodgins, 2004), who are at high
risk for the development of both major depression and BD
(Birmaher et al., 2009; Hodgins, Faucher, Zarac, & Ellenbo-
gen,2002;Lapalme,Hodgins,&LaRoche,1997).Wehypoth-
esized that one facet of the genetic vulnerability for mood dis-
orders is expressed as the trait of neuroticism (Kendler, Gatz,
Gardner, & Pedersen, 2006). That is, the child who inherits
the genes associated with mood disorders inherits a tendency
to react emotionally to stressors and daily hassles. This ten-
dency is promoted by being raised by one or two parents
with high levels of neuroticism who themselves display a pat-
ternofoverreactivitytodailylifeeventsand ineffective coping
withstress.Theparents’behaviorcreatesafamilyenvironment
that is stressful, chaotic, and unpredictable and that fails to
teachthechildappropriateskillsforcopingwithstress(Chang,
Blasey, Ketter, & Steiner, 2001; Ellenbogen & Hodgins,
2004). In addition, these parents do not provide adequate sup-
port and structure for their children (Ellenbogen & Hodgins,
2009). The family environment and parenting practices, we
postulate, in interaction with a genetic vulnerability, lead to
deficits in emotional, behavioral, and physiological regulation
amongthechildren(Derryberry&Rothbart,1997;Ellenbogen
& Hodgins, 2009). Thus, parents with BD may transmit genes
to their offspring that make them vulnerable to major affective
disordersandaswell,bytheirbehaviorandparentingpractices,
create a family environment that enhances this genetic vulner-
ability. Similarly, the offspring who inherit a genetic vulner-
ability for affective disorders, as they grow up, may seek out
environments that are consistent with their own inability to
cope with daily life and stress (Rutter, 2007; Rutter, Moffitt,
& Caspi, 2006). In sum, the personality of parents is postu-
lated to elicit a number of adverse environmental processes
that have a negative impact on offspring directly and through
gene–environment interplay.
We have previously examined the relationship between
parents’ neuroticism and functioning of OBD compared to
ONMD.Thiscross-sectionalinvestigationshowedthatamong
the parents, a high level of neuroticism was associated with a
broad range of difficulties, including poor social and occupa-
tional functioning, lower educational attainment, problems in
intimate relationships, low levels of social support, more
negative life events that they caused themselves, ineffective
strategies for coping with stress, and nonoptimal parenting
practices (Ellenbogen & Hodgins, 2004). After controlling
for parents’ mood disorders, psychosocial functioning, and
parenting practices, high levels of neuroticism in the parents
wasarobustpredictorofinternalizing andexternalizing prob-
lems among the offspring in childhood. The present study
was designed to follow-up these findings, by examining the
effects of parents’ neuroticism on offspring’s interpersonal
functioning 10 years later. The study also aimed to determine
if the internalizing and externalizing problems exhibited in
middle childhood mediated the association between parents’
neuroticism and offspring’s interpersonal functioning in late
adolescence–early adulthood. It is posited that both internal-
izing and externalizing problems in childhood are important
markers of risk for future affective disorders. In addition to
the link between childhood externalizing problems and later
BD (Carlson, Bromet, & Sievers, 2000), there is recent pro-
spective evidence that, among the OBD, childhood anxiety
disorders double the risk of developing an affective disorder
in late adolescence or early adulthood (Duffy, Alda, Hajek,
Sherry, & Grof, 2010). Thus, internalizing and externalizing
problems in childhood are expected to be part of the develop-
mental trajectory leading to interpersonal problems in late
adolescence–early adulthood and subsequently to affective
disorders.
Poor interpersonal functioning, which reflects persistent
difficulties in establishing and maintaining satisfying rela-
tionships with family members, peers, colleagues, and ro-
mantic partners, may represent a key link between early fam-
ily risk factors and the development of an affective disorder
(Hammen, 2005). For instance, in a sample of 800 mothers
and their 15-year-old offspring, adolescents’ interpersonal
difficulties were strongly related to their own level of depres-
sionandtheassociationwasmorepronouncedamongtheoff-
spring of mothers with, than without, a diagnosis of depres-
sion (Hammen, Shih, Altman, & Brennan, 2003). Similarly,
adult offspring of depressed parents were found to have
poorerfunctioning at work,intheir marriage, andwith family
members than the ONMD (Weissman, Warner, Wickrama-
ratne, Moreau, & Olfson, 1997). Consequently, interpersonal
functioning may play an important role in the transmission of
depression from one generation to the next (Cicchetti & Toth,
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
574

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1998; Goodman & Gotlib, 1999), through both genetic and
environmental mechanisms.
The present study tested three hypotheses. First, based on
our previous findings (Ellenbogen & Hodgins, 2004), we hy-
pothesizedthathighneuroticisminparents,assessedwhenoff-
spring were children, would predict interpersonal dysfunction
in the offspring in late adolescence–early adulthood. Interper-
sonalfunctioninginthisdevelopmentalperiodmaybeparticu-
larly critical as it may influence several major life transitions,
such as moving out of the parents’ home, entering higheredu-
cation or the work place, dating, sexual relationships, and so
forth (Laursen & Collins, 1994; Newman, Caspi, Moffitt, &
Silva, 1997).
Second, we hypothesized that the association between
parents’ neuroticism and offspring interpersonal functioning
would be partly mediated by offspring internalizing and ex-
ternalizing problems in middle childhood. Based on previous
studies, weexpectedthattherewouldbesignificantcontinuity
between the offspring’s levels of internalizing and externaliz-
ing problems in childhood and their interpersonal functioning
in adulthood (e.g., Broidy et al., 2003; Goodwin, Fergusson,
& Horwood, 2004; Rutter, Kim-Cohen, & Maughan, 2006).
Third, given that the negative consequences of high neu-
roticism in parents on offspring are purportedly amplified
in families having a parent with BD (Ellenbogen & Hodgins,
2004), and that there is a strong genetic association between
mood disorders and neuroticism (Hettema, Neale, Myers,
Prescott, & Kendler, 2006; Kendler et al., 2006), we hypoth-
esized that the association between parents’ neuroticism and
offspring’s functioning in late adolescence–early adulthood
would be stronger among the OBD than the ONMD. In addi-
tion, in order to determine whether the association between
parents’ personality and offspring functioning was specific
to the trait of neuroticism, we examined the associations be-
tween parents’ traits of extraversion, agreeableness, conscien-
tiousness, and openness to experience and offspring’s inter-
personal functioning.
Method
Participants
Thesampleincluded62maleand62femaleoffspring,from78
families, who were participating in an ongoing prospective
study of families with a parent diagnosed with BD or parents
with no mental disorder. Of the original sample, 18% of the
OBD and 17% of the ONMD have refused to participate or
have not been located as of August 2009. When offspring
werebetween4and12yearsold,parentshadratedtheirbehav-
ior using the Child Behavior Checklist (CBCL; Achenbach,
1991). The CBCL ratings for offspring who did and who did
not participate in the present wave of data collection were sim-
ilar among both the OBD and ONMD. At baseline, the inclu-
sion criteriafor the study were (a) adults raising at least one bi-
ologicalchildagedbetween4and14years,(b)fluencyineither
EnglishorFrench,and(c)beingraisedandeducatedinCanada.
Familiesinwhicheitheraparentorchildhadachronicphysical
diseaseorhandicapand/oranIQbelow70wereexcluded.Par-
ents with a diagnosis of BD, their spouses, and children were
recruited from psychiatric outpatient clinics and from patient
advocacy and support groups. All parents completed an inter-
view with the Structured Clinical Interview for DSM-III-R
(SCID-I; Spitzer, Williams, Gibbon, & First, 1992). Parents
with BD reported, on average, symptoms 7.85 years (SD ¼
8.65 years) before the birth of the child included in the study.
Familiesinwhichparentshadnomentaldisorderwererecruited
in the same neighborhoods as the families with BD, through
physicians’ offices and community organizations. None had a
current Axis I disorder. Five parents of ONMD met criteria
for a past drug use or anxiety disorder (for more information
regarding the original sample, see Ellenbogen & Hodgins,
2004). Parents were mostly White, middle-class, and French
speaking.
In the present follow-up study, the offspring ranged in age
from 15 to 27 years (M ¼ 19.81, SD ¼ 3.01; see Table 1).
Sixty-five offspring, from 44 families, had a parent with BD,
and 59 offspring,from 34families,had parents withnomental
disorder. Ofthe 44families withBD, 20families hada mother
with BD and 24 families had a father with BD. In addition, 14
families had both a parent with BD and a parent with major
depression. At the time of the present data collection, 35% of
the offspring were living with both biological parents (14
OBD,29ONMD),14%werelivingwithonebiologicalparent
(16 OBD, 2 ONMD), 4% were living with one biological par-
ent and a stepparent (4 OBD, 1 ONMD), 47% were living ei-
theralone,witharoommateorapartner(31OBD,27ONMD),
93% were in school (59 OBD, 56 ONMD), and 52% were
working (33 OBD, 32 ONMD).
Thirty-five offspring (22 OBD, 13 ONMD) met criteria
for a current diagnosis according to DSM-IV (American Psy-
chiatric Association, 1994). Current diagnoses included four
mood disorders (3 OBD, 1 ONMD), 27 anxiety disorders (19
OBD, 8 ONMD), 15 substance-related disorders (10 OBD, 5
ONMD), and 5 other diagnoses (2 OBD with ADHD, 1 OBD
withhypochondriasis,1ONMDwithanorexianervosa,and1
ONMD with Tourette syndrome).
Measures
Time 1 (1995–1997; children aged 4–12 years old).
Revised NEO Personality Inventory (NEO-PI-R). Parents
completed this self-report questionnaire (Costa & McCrae,
1992) that includes 240 items assessing the traits of neuroti-
cism, extraversion, agreeableness, openness, and conscien-
tiousness. High internal consistency, with coefficients rang-
ing from 0.89 to 0.95, and temporal stability over 6 years
have been reported (Costa, Herbst, McCrae, & Siegler,
2000; Rolland, Parker, & Stumpf, 1998). Studies have also
demonstrated convergent and discriminant validity of the
NEO-PI-R (Costa & McCrae, 1992b). Excellent psychomet-
ric proprieties have been demonstrated with the French trans-
lation (Rolland et al., 1998). For 115 offspring, the mean of
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
575

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both parents’ scores for each of the five traits was used in the
analyses, and for 9 offspring, scores from one parent only
were used.1
CBCL. Parents completed the ParentReport Form (PRF) of
theCBCL(Achenbach,1991)toassessinternalizingandexter-
nalizing behaviors in their child. The CBCL PRF has good re-
liability and validity (Barkley, 1988). One-week and 3-month
test–retestreliabilitiesforexternalizingproblemswerereported
to be 0.95 and 0.84, respectively (Barkley, 1988). Concurrent
validityhasbeenestablishedbetweentheCBCLandotherpar-
ent-reported behavior scales and the Diagnostic Interview
Schedule for Children (Barkley, 1988).CBCL scores were ob-
tained for 103 offspring. For 95 offspring, the mean of ratings
from two parents was used inthe analyses,and for 8 offspring,
ratings from one parent were used.
Time 2 (2006–2008; children aged 15–27 years old).
UCLALife StressInterview.This semistructuredinterview
(Adrian & Hammen, 1993; Hammen, 1991) was developed
to assess interpersonal and noninterpersonal functioning
in nine domains during the past 6 months. Functioning in
each domain is coded on a 5-point scale, using specific be-
havioral anchor points. Higher scores reflect poorer function-
ing. For example, in the social life domain, a score of 1 is de-
scribed as Exceptional social life—many good friends, very
popular and engages in frequent social activities, gets along
well with others, no conflict, and a 5 is described as Severe
social problems with no friends, totally isolated from peers
or frequent conflicts and fights, rejected by peers (Hammen
et al., 2003). Interpersonal functioning was defined as the
sum of scores in the domains of close friends, social life, ro-
mantic relationships, and family relationships; noninterper-
sonal functioning was defined as the sum of scores in the do-
mains of school, work, finances, health, and health of family
members (Eberhart & Hammen, 2006; Hammen, Brennan, &
Shih, 2004; Rudolph et al., 2000). Audio and/or video digital
recordings of 14 interviews were rated independently by a
second interviewer to estimate interrater reliability. Intraclass
correlation coefficients revealed high reliability for all do-
mains, with a mean of 0.82, similar to coefficients obtained
in previous studies (Eberhart & Hammen, 2006; Hammen,
Shih, & Brennan, 2004; Shih, Eberhart, Hammen, & Bren-
nan, 2006).
Diagnostic interviews. TheSCID-I(First,Gibbon,Spitzer,
& Williams, 2002) is a semistructured diagnostic interview
designedtoassessmentaldisorders.Manystudieshaveshown
the SCID-I to be a reliable and valid diagnostic instrument
(e.g., Ramirez-Basco et al., 2000; Zanarini & Frankenburg,
2001). The SCID-I was administered to offspring aged 19 or
Table 1. Parent and offspring variables
OBD ONMDTotal
Fa
N
Gender (male/female)
6559124
62:62 35:3027:32
M+SDM+SDM+SD
Time 1 (1995–1997)
Offspring age (years)
Offspring CBCL t score
Internalizing
Externalizing
Parents’ neuroticism t score
8.43+2.517.67+2.36 8.06+2.45 3.02
52.97+9.99
53.24+10.69
53.16+7.56
47.75+7.59
44.61+9.17
45.99+5.69
50.49+9.27
49.14+10.85
49.75+7.61
8.41**
17.93***
33.48***
Time 2 (2006–2008)
Offspring age (years)
Offspring functioningb
Interpersonal
Noninterpersonal
20.26+3.19 19.31+2.7419.81+3.01 3.76
2.17+0.52
2.33+0.47
1.89+0.35
1.99+0.32
2.04+0.47
2.17+0.44
13.76***
20.24***
Note:OBD,offspringofparentswithbipolardisorder;ONMD,offspringofparentswithnomentaldisorder;CBCL,ChildBehaviorChecklist.
aMain effect of group (difference between the bipolar and no mental disorder families).
bHigher scores represent worse functioning in interpersonal and noninterpersonal domains, as rated on a 5-point scale.
**p , .01. ***p , .001.
1. From a conceptual level, we view the use of mean parent personality
scores as a more conservative and accurate approach to understanding
the influence of parent’s personality on offspring outcomes. In this way,
the effects of one parent who is high on neuroticism can be offset by
the buffering effects of a parent who is stable (i.e., low on the trait). Fur-
thermore, from a statistical viewpoint, the use of data from multiple in-
formants improves the distribution of data points, minimizes outliers,
and therefore reduces the likelihood of spurious results.
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
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Page 5

above (n ¼ 77). For children aged 7 to 18 years old (n ¼ 47),
the Kiddie-Schedule for Affective Disorders and Schizophre-
nia—Present and Lifetime version (K-SADS-PL; Kaufman,
Birmaher, Brent, & Rao, 1997) was used. It is highly reliable
in children and adolescents and considered to be an excellent
interview for identifying affective disorders in youth (Kauf-
man et al., 1997; Kaufman, Schweder, Hilsenroth, & Segal,
2004). In the current follow-up study, both the SCID-I and
K-SADS-PL were administered by experienced clinicians.
Using audio and/or video digital recordings, 15 interviews
(6 SCID-I and 9 K-SADS) were rated independently bya sec-
ond clinician. Interrater reliability for diagnoses was high: the
k coefficients were 0.82, 0.71, and 1.0 for affective, anxiety,
and substance use disorders, respectively.
Procedure
At baseline, parents with BD and with no mental disorder
were recruited in Montre ´al and surrounding regions. Follow-
ing a telephone screening, parents completed the SCID-I in-
terview, and a number of questionnaires including the
NEO-PI-R and CBCL PRF at home or at the university (for
full list of measures, see Ellenbogen & Hodgins, 2004). Par-
ents with BD were euthymic when completing question-
naires.Spouseswerecontactedandcompleted thesameinter-
viewsandquestionnaires,andoffspring betweentheagesof4
and 12 years were assessed.
When offspring reached late adolescence–early adult-
hood, they were contacted by telephone and invited to parti-
cipate in the study. Offspring, and their guardian if they were
17 years or younger, provided written consent for participa-
tion in the study. They completed a diagnostic interview
(SCID-I or K-SADS) and the UCLA Life Stress Interview
conducted by a clinical psychologist. Offspring also com-
pleted questionnaires, underwent computer-based informa-
tion processing tasks (data not reported here), and provided
samples of saliva at home. Participants received an honorar-
ium of $150 CAN for participating in the current wave of
data collection. All procedures were approved by the Human
Research Ethics Committee of Concordia University.
Data analysis
Datawerescreenedforoutliers,definedasscoresatleast3SD
from the mean, and violations of normality. Scores for the
ninedomainsofthechronicstressinterview,aswellastheag-
gregated mean scores, were positively skewed and therefore
were log-10 transformed. All analyses were conducted on
transformed data. However, to facilitate the interpretation of
data, nontransformed data are presented in the text and tables.
Hierarchical multiple regressions were performed on the
mean scores for interpersonal and noninterpersonal function-
ing separately. In both regressions, independent variables
were entered in the following steps: (a) offspring age, off-
spring gender, and presence or absence of any current disor-
der in the offspring; (b) parents’ neuroticism score. To deter-
mine whether the association between offspring functioning
and parents’ personality was specific toneuroticism, analyses
examined parents’ traits of extraversion, agreeableness, con-
scientiousness, and openness to experience as predictors of
offspring interpersonal functioning.
Mediation analyses were conducted using Baron and Ken-
ny’s method (1986), which recommends testing mediation
usingthreeregressionmodels.InStep1,theindependentvari-
able must predict the dependent variable. In Step 2, the medi-
ator must predict thedependentvariable.InStep 3, when both
the mediator and the independent variable are in the regres-
sion equation, the initial association between the independent
and dependent variables must be significantly reduced. These
three steps were followed by the Sobel test, a more rigorous
procedure to test for mediation (MacKinnon, Lockwood,
Hoffman,West,&Sheets,2002).AsignificantSobel test sug-
geststhat the indirecteffect of the independent variable on the
dependent variable through the mediator is different from
zero, and thus, that mediation is present. Finally, in order to
examinewhethera parental diagnosis of BD oroffspring gen-
der moderated the strength of the mediations, we conducted
moderated mediation analyses, following recommendations
outlined in Muller, Judd, and Yzerbyt (2005).
All analyses except the moderated mediations were con-
ducted with and without siblings (using random deletion) to
determine if the inclusion of siblings (i.e., nonindependence)
may have biased the results. Both sets of analyses yielded
similar findings; we therefore included all participants in
the analyses.
Results
Parents’ neuroticism and offspring’s functioning in late
adolescence–early adulthood
As presented in Table 1, the OBD reported poorer interper-
sonal and noninterpersonal functioningthan theONMD. Cor-
relationsbetween scoresforparents’personalitytraitsandoff-
spring’s functioning in late adolescence–early adulthood and
in childhood are presented in Table 2. The hierarchical multi-
ple regression equation predicting offspring’s interpersonal
functioning was significant, accounting for 20.2% (R2) of
the variance (see Table 3, top panel). Parents’ neuroticism
scores accounted for 4.2% (change in R2) of the variance in
interpersonal functioning in the offspring. In addition, the
presenceofacurrentmentaldisorderintheoffspringwasasig-
nificant predictor of interpersonal functioning, such that off-
spring with current mental disorders reported higher levels
of interpersonal difficulties than those with no mental disor-
ders. Gender was also a significant predictor, indicating that
male offspring reported poorer interpersonal functioning
than female offspring.
The regression equation predicting noninterpersonal func-
tioning among offspring was significant and accounted for
14.2% (R2) of the variance (see Table 3, bottom panel). In
contrast to the results for interpersonal functioning, parents’
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
577

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neuroticism scores were not predictive of offspring’s func-
tioning in noninterpersonal domains. The presence of a cur-
rent mental disorder in the offspring was a significant pre-
dictor of noninterpersonal functioning, such that offspring
with mental disorders reported poorer functioning in nonin-
terpersonal domains than nondisordered offspring. These re-
sults indicate that having a parent with high neuroticism is
predictive of higher levels of interpersonal, but not noninter-
personal, difficulties, and that this association is independent
of the well-known effects of current psychopathology on
functioning.
Each of the above analyses was repeated after the random
deletion of siblings within each family, so that there was only
one sibling per family. The hierarchical multiple regression
equationpredicting interpersonal functioning amongoffspring
was significant: R ¼ .51, F (4, 71) ¼ 6.15, p , .001. Parents’
neuroticism scores (b ¼ 0.22, t ¼ 2.09, p , .05) and gender
(b ¼ 20.26, t ¼ 22.52, p , .05) were significant predictors
of interpersonal functioning. The regression equation predict-
ing noninterpersonal functioning among offspring was signif-
icant:R¼.42,F(4,71)¼3.80,p,0.01;parents’neuroticism
scores were not predictive of offspring functioning in nonin-
Table 2. Correlations among parents’ and offspring’s variables
1234567
1. Parents’ neuroticism
2. Parents’ agreeableness
3. Parents’ conscientiousness
4. Offspring interpersonal functioning
5. Offspring noninterpersonal functioning
6. Offspring childhood internalizing problems
7. Offspring childhood externalizing problems
—
20.32**
20.36**
0.23*
0.26**
0.44**
0.55**
—
0.42**
20.24*
0.02
20.18
20.21*
—
20.16
20.03
20.07
20.15
—
0.41**
0.41**
0.41**
—
0.16
0.36**
—
0.68**—
*p , .05. **p , .01.
Table 3. Parents’ level of neuroticism as predictor of offspring outcomes: Results of a hierarchical multiple regression
analysis
Predictors
r
Partial r
b
tR
Adj. R2
DF
Offspring Interpersonal Functioning in Late Adolescence–Early Adulthood
Step 1
Age
Gender
Offspring current disorder
Total step
Step 2
Age
Gender
Offspring current disorder
Parents’ neuroticism
Total step
.13.060.06
20.24
0.33
0.69
22.78**
3.75***
2.21
.32
2.25
.33
0.400.147.52***
.070.07
20.21
0.28
0.21
0.79
22.45*
3.25**
2.47*
2.22
.29
.22.29
0.45 0.186.09*
Offspring Noninterpersonal Functioning in Late Adolescence–Early Adulthood
Step 1
Age
Gender
Offspring current disorder
Total step
Step 2
Age
Gender
Offspring current disorder
Parents’ neuroticism
Total step
.16.10 0.10
20.15
0.29
1.91
21.75
3.20**
2.13
.30
2.16
.28
0.35 0.965.30**
.110.11
20.13
0.25
0.16
1.91
21.48
2.80**
1.79
2.14
.30
.16.22
0.380.11 3.12***
Note: n ¼ 122; adj. R2, adjusted R2; partial r, partial correlation.
*p , .05. **p , .01. ***p , .001.
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
578

Page 7

terpersonal domains (b ¼ 0.09, t ¼ 0.81, ns). The results of
these analyses indicate that the present findings were not in-
fluenced by the nonindependence of data from offspring
within the same families.
Other personality traits of parents and offspring’s
functioning in late adolescence–early adulthood
To determine if offspring’s functioning in interpersonal and
noninterpersonal domains was associated with other person-
ality traits of their parents, similar analyses were undertaken.
Parents’ extraversion and openness to experience were not
significantpredictorsofoffspring’sinterpersonalornoninter-
personal functioning. Parents’ levels of agreeableness (b ¼
232, t ¼ 23.54, p , .001) and conscientiousness (b ¼
20.23, t ¼ 22.61, p , .01) were negatively associated
with offspring’s functioning in interpersonal, but not non-
interpersonal, domains.
Is the association between parents’ personality and
offspring functioning in late adolescence–earlyadulthood
mediated by the offspring’s childhood problem
behaviors?
A series of multiple regressions were conducted to determine
whether scores for internalizing and externalizing problems,
measured when the offspring were between 4 and 12 years
of age, mediated the associations between parents’ personal-
ity traits andoffspring’s interpersonal functioning inlate ado-
lescence–early adulthood. The analyses included 103 partic-
ipants for whom CBCL scores were available.
Parents’ neuroticism was a significant predictor of off-
spring’s interpersonal functioning (b ¼ 0.21, t ¼ 2.47, p ,
.05) and offspring’s childhood internalizing scores (b ¼
0.43, t ¼ 4.97, p , 0.001; see Figure 1a). When scores for
parents’ neuroticism and offspring’s childhood internalizing
problemswerebothentered togetherinto theregression equa-
tion, childhood internalizing problems predicted offspring’s
interpersonal functioning later in life (b ¼ 0.23, t ¼ 2.29, p
, .05), but parents’ neuroticism was no longer a significant
predictor of offspring’s functioning (b ¼ 0.18, t ¼ 1.90,
ns). According to Baron and Kenny (1986), these results sug-
gest partial mediation of the association between parents’
neuroticism and offspring’s functioning by childhood inter-
nalizing problems. The results of the Sobel test, estimating
whether the indirect effect is significantly different from
zero, supported this view, butfell short ofconventionalstatis-
tical significance (Z ¼ 1.86, p ¼ .063).
Next, we examined whether offspring childhood external-
izingscoresmediatedtheassociationbetweenparents’neurot-
icism and offspring’s interpersonal functioning later in life.
Parents’ neuroticism predicted offspring’s interpersonal func-
Figure 1.Standardizedregression coefficients for themediation models.(a) Apartial mediation, withinternalizingproblemsasthe mediatorand
(b) a partial mediation through externalizing problems. The numbers in parentheses are the coefficients of the association between parents’ neu-
roticism and offspring functioning when the mediator is in the regression equation. *p , .05. **p , .01. ***p , .001.
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
579

Page 8

tioning(b¼0.21,t¼2.47,p,.05)andoffspring’schildhood
externalizing problems (b ¼ 0.56, t ¼ 6.69, p , .001; see
Figure 1b). When scores for parents’ neuroticism and child-
hood externalizing problems were both entered intothe regres-
sionequation,childhoodexternalizingproblemspredictedlater
offspring’s interpersonal functioning (b ¼ 0.31, t ¼ 3.03, p ,
.01), while parents’ neuroticism was no longer a significant
predictor (b ¼ 0.12, t ¼ 1.13, ns). The Sobel test indicated
thatthemediationwassignificant (Z¼2.73,p,.01),meaning
thattheassociationbetweenparents’neuroticismandoffspring
interpersonalfunctioningwaspartiallymediatedthroughchild-
hood externalizing problems in offspring.
The statistical analyses were repeated after the random de-
letionofsiblingswithineachfamily,sothattherewasonlyone
sibling per family. Mediation analyses showed that parents’
neuroticism was a significant predictorof offspringinternaliz-
ing (b ¼ 0.44, t ¼ 4.26, p , .001) and externalizing scores (b
¼ 0.55, t ¼ 5.32, p , .001). When scores for parents’ neurot-
icism and childhood internalizing/externalizing problems
were entered together into the regression equation, childhood
internalizing problems (b ¼ 0.27, t ¼ 2.12, p , .05) and ex-
ternalizing problems (b ¼ 0.27, t ¼ 2.09, p , .05) predicted
interpersonal functioning later in life but parents’ neuroticism
was no longer a significant predictor of functioning in off-
spring. The results of these analyses indicate that the present
findings were not influenced by the nonindependence of
data from offspring within the same families.
Because parents’ traits of conscientiousness and agreeable-
ness were negatively associated with offspring’s interpersonal
functioning, analyses were undertaken to determine if off-
spring’s childhood problems mediated these associations. Par-
ents’ scores for conscientiousness did not predict childhood
internalizing or externalizing scores (b ¼ 20.07, t ¼ 20.74,
ns, and b ¼ 20.16, t ¼ 21.58, ns, respectively), indicating
thattheassociationbetweenparents’conscientiousnessandoff-
spring’s interpersonal functioning is not mediated through
childhood internalizing or externalizing problems in offspring.
Parents’ scores for agreeableness were associated with
childhood internalizing (b ¼ 20.30, t ¼ 23.36, p , .001)
and externalizing problems (b ¼ 20.24, t ¼ 22.36, p ,
.05) in offspring. When scores for parents’ agreeableness and
offspring’s childhood internalizing problems were entered to-
gether into the regression equation, childhood internalizing
problems predicted later interpersonal functioning in offspring
(b ¼ 0.35, t ¼ 3.74, p , .001), butparents’ agreeablenesswas
nolongerasignificantpredictorofinterpersonalfunctioningin
offspring(b¼20.16,t¼21.75,ns).TheSobeltestindicated
that the mediation was not significant (Z ¼ 21.69, ns). Medi-
ation analyses were then conducted forexternalizing problems
in childhood. When scores for parents’ agreeableness and
childhood externalizing problems in offspring were both en-
tered into the regression equation, offspring’s childhood exter-
nalizing problems predicted later interpersonal functioning in
offspring (b ¼ 0.36, t ¼ 4.04, p , .001), but parents’ agree-
ableness was no longer a significant predictor (b ¼ 20.14,
t ¼ 21.54, ns). The Sobel test indicated that the mediation
was significant (Z ¼ 22.00, p , .05), meaning that the asso-
ciation between parents’ agreeableness and offspring’s inter-
personal functioning was partially mediated through the off-
spring’s externalizing behaviors in middle childhood.
Is the association between parents’ personality and
offspring functioning in late adolescence–earlyadulthood
mediatedby the offspring’schildhoodsocial competence?
In order to verify whether the association between parents’
neuroticism and offspring’s functioning in late adoles-
cence–early adulthood was associated with the offspring’s
social competence in childhood, further mediation analyses
were undertaken using the social relations competence scale
of the CBCL’s PRF. Parents’ neuroticism was not a signifi-
cant predictor of social competence assessed when the off-
spring were children (b ¼ 20.01, t ¼ 20.09, ns). When
scores for parents’ neuroticism and social competence were
entered together into the regression equation, parents’ neurot-
icism predicted offspring interpersonal functioning in late
adolescence–early adulthood (b ¼ 0.21, t ¼ 2.46, p , .05),
but social competence was not a significant predictor (b ¼
20.05; t ¼ 20.55, ns). Overall, these analyses suggest that
social competence in childhood does not mediate the associa-
tionbetweenparents’neuroticismandoffspring interpersonal
functioning in late adolescence-early adulthood.
Does parents’ bipolar disorder moderate the observed
mediations?
We examined whether a parental diagnosis of BD moderated
the strength of the mediated associations that were found be-
tweenparents’personalityandoffspring’sinterpersonalfunc-
tioning in late adolescence–early adulthood. To accomplish
this, we conducted exploratory regression analyses to test
for moderated mediation (see Table 4). In the first step of
theanalyses,weincludedoffspring’s age,gender,andcurrent
diagnosisascontrolvariables.Inthesecondstep,weincluded
parents’ neuroticism, parent BD (present or absent), and the
mediator when appropriate. In the third step, we included
the interaction terms.
We first examined whether parents’ BD moderated the
mediation of offspring’s childhood internalizing problems on
the association between parents’ neuroticism and offspring’s
interpersonal functioning in late adolescence–early adulthood.
The first equation showed that the interaction between parents’
neuroticism and parent BD did not predict offspring interper-
sonal functioning,suggestingthat the effect ofparents’neurot-
icism on later functioning in offspring is not moderated by the
presence of BDinparents(seeTable 4, top panel).Thesecond
equationshowed that parents’ BDwasa significant moderator.
The association between parents’ neuroticism and offspring’s
internalizing problems in childhood was significantly stronger
among the OBD than the ONMD. Childhood internalizing
problems,however,predictedinterpersonalfunctioningequally
among all offspring. Given the small sample size and the ab-
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
580

Page 9

senceofassociationbetweenneuroticismandoffspring’sinter-
personal functioning in the first set of equations, these results
should be interpreted cautiously.
We then examined whether parents’ BD moderated the
mediation of offspring’s childhood externalizing problems
on the association between parents’ neuroticism and off-
spring’s interpersonal functioning in late adolescence–early
adulthood. No moderation of the mediation by parents’ BD
was detected (see Table 4, bottom panel).
An analysis was undertaken to examine whether the pre-
sence of BD among the parents moderated the mediation by
offspring’s childhood externalizing problems of the associa-
tion between parents’ agreeableness and later interpersonal
functioninginoffspring.Nointeractiontermsweresignificant,
suggesting that parents’ BD did not moderate the mediation.
Doesoffspringgendermoderatetheobservedmediations?
Finally, we were interested in examining whether offspring
gender moderated the strength of the mediated associations
that were found between parents’ personality traits and off-
spring’s interpersonal functioning in late adolescence–early
adulthood. We thus conducted exploratory regression analy-
ses to test for moderated mediation, as described in the pre-
vious section. Overall, gender did not moderate anyof the as-
sociationsfoundbetweenparentalneuroticism,CBCLscores,
and interpersonal functioning.
Discussion
Inthis prospective10-yearstudyofyouth at high andlow risk
foraffectivedisorders,weexamined theassociations between
parents’ personality traits, offspring’s internalizingand exter-
nalizing problems in middle childhood, and offspring’s inter-
personal functioning in late adolescence–early adulthood.
Three hypotheses were tested. The first hypothesis, that par-
ents’ neuroticism would predict interpersonal functioning in
offspring, was supported, even after controlling for the off-
spring’s age, gender, and current disorders. Although a few
studies have examined the association between parents’ neu-
roticism and child psychosocial outcomes (Degnan, Hender-
son, Fox, & Rubin, 2008; Kochanska et al., 1997; Sullivan,
1997), the present investigation is the first, to our knowledge,
to report that parents’ personality may have a long-term influ-
ence on interpersonal functioning in offspring. Conversely,
parents’ neuroticism did not predict offspring’s functioning
in noninterpersonal domains such as school, work, finances,
and health habits. Thus, parents’ neuroticism specifically in-
fluenced offspring’s functioning in interpersonal domains in
late adolescence–early adulthood.
Our second hypothesis was that the association between
parents’ neuroticism and interpersonal functioning in off-
spring would be mediated in part by offspring’s childhood
internalizing and externalizing problems. Although the hy-
pothesis was supported, the mediation through childhood in-
ternalizing problems was modest, whereas that of external-
izing problems was stronger. The finding of an association
between parents’ neuroticism and childhood problems in off-
spring is consistent with results from our previous cross-
sectional study undertaken when the offspring were children
(Ellenbogen & Hodgins, 2004) and from other studies (Ko-
chanska et al., 1997; Kurdek, 2003). The present study ex-
tends these previous findings by showing that offspring’s
problems in middle childhood are associated with poor inter-
Table 4. Results of regression models estimating moderated mediation with internalizing problems and externalizing
problems
Equation 1Equation 2Equation 3
Criterion: Offspring
Interpersonal Functioning
Criterion: Offspring
Childhood CBCL Scores
Criterion: Offspring
Interpersonal Functioning
Predictors
b
tp
b
tp
b
tp
Moderated Mediation Through Internalizing Problems
Parents’ neuroticism
Parent BD
Parents’ Neuroticism×Parent BD
Offspring internalizing score
Parent BD×Offspring Internalizing Score
0.12
0.20
20.03
1.20
2.11
20.29
ns
0.32
0.12
0.19
3.01
1.20
1.97
,.01
ns
<.05
0.10
0.18
20.02
0.20
0.07
0.88
1.75
20.15
1.96
0.66
ns
ns
ns
.053
ns
,.05
ns
Moderated Mediation Through Externalizing Problems
Parents’ neuroticism
Parent BD
Parents’ Neuroticism×Parent BD
Offspring externalizing score
Parent BD×Offspring Externalizing Score
0.12
0.20
20.03
1.20
2.11
20.29
ns
0.44
0.19
0.06
4.32
1.92
0.65
,.001
.058
ns
0.05
0.15
0.00
0.27
0.07
0.44
1.50
20.03
2.57
0.74
ns
ns
ns
,.05
ns
,.05
ns
Note: Multiplied terms represent interactions. CBCL, Child Behavior Checklist; BD, bipolar disorder diagnosis.
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
581

Page 10

personal functioning 10 years later. These results are in line
with evidence showing that internalizing and externalizing
problems in childhood exhibit continuity over time and in-
crease the risk of similar difficulties and mental disorders in
earlyadulthood(Broidyet al., 2003;Caspi,Moffitt, Newman,
& Silva, 1996; Goodwin et al., 2004; Shiner, Masten, & Ro-
berts, 2003). Thus, childhood problems in offspring mediated
the association of parents’ neuroticism and offspring’s inter-
personal functioning in late adolescence–early adulthood.
Our third hypothesis, that parents’ neuroticism would be
more strongly associated with interpersonal functioning
among the OBD than the ONMD, and that the mediation of
offspring childhood problems would be stronger in high-
risk than low-risk families, was partially supported. Despite
the small sample size, the diagnosis of BD in parents moder-
ated the association between parents’ neuroticism and child-
hood internalizing problems among offspring, but not the as-
sociation between childhood internalizing problems and
interpersonal functioning a decade later. In other words, off-
spring whose parents had both high neuroticism scores and a
diagnosis of BD were more likely to have presented internal-
izing problems in middle childhood than the offspring of par-
ents with either BD or high neuroticism alone. Internalizing
problems in middle childhood increased the risk for poor in-
terpersonal functioning 10 years later, regardless of the pres-
ence of BD among the parents. These data support recent
evidence highlighting the importance of anxiety in childhood
as a precursor to the development of an affective disorder
among offspring of parents having BD (Duffy et al., 2010;
Goldstein et al., 2010). In sum, the results suggest a pattern
of relative continuity across generations in families having a
parent with BD, but not in nonaffected families, defined by
a trajectory of high emotionality in parents, offspring inter-
nalizing problems in childhood, and interpersonal dysfunc-
tion in late adolescence and early adulthood.
Few studies have examined the association between par-
ents’ neuroticism and offspring outcomes among parents
with a mental disorder. The few studies that have addressed
this issue have, for the most part, been cross-sectional and fo-
cusedoninfancyandchildhood(Brook,Whiteman,&Zheng,
2002;Ellenbogen& Hodgins,2004;Sullivan,1997). Further-
more, differences in themeasures ofparents’ personality traits
and outcomes among offspring make it difficult to compare
the results of these studies. The paucity of research on off-
spring of parents with mental disorders might stem from the
challenge of distinguishing personality and symptomatology.
Several models have been posited to explain the associations
between personality traits, especially neuroticism, and mood
disorders (fora review, see Klein, Durbin, Shankman, & San-
tiago,2002).Overall,theextantliteraturesuggeststhatneurot-
icism is a stable trait (Costa et al., 2000) that contributesto the
development of affective disorders (Fanous, Neale, Aggen, &
Kendler, 2007).
Although the present study focused on the trait of neuroti-
cism because it is strongly associated with affective disorders
(Bagby, Bindseil, Schuller, & Rector, 1997; Kendler, Kuhn,
& Prescott, 2004; Widiger & Trull, 1992), analyses were con-
ducted to determine if other personality traits of the parents
were associated with functioning among offspring. Parents’
traits of conscientiousness and agreeableness, but not extra-
version and openness to experience, were both negatively as-
sociatedwithinterpersonaldifficultiesamongoffspringinlate
adolescence–earlyadulthood.Agreeablenessisthetendencyto
becompassionate,kind,andcooperative;conscientiousnessis
thetendency toaim forachievementandtobe self-disciplined
and hardworking (Costa & McCrae, 1992). Low agreeable-
ness in parents, but not low conscientiousness, predicted
more externalizing problems among the offspring in middle
childhood, which in turn predicted poor interpersonal func-
tioning 10 years later. Thus, parents’ traits of agreeableness
and neuroticism were associated with offspring externalizing
problems in middle childhood and interpersonal functioning
among offspring later in life. By contrast, only the parental
trait of neuroticism was associated with internalizing behav-
iorsamongoffspringinmiddlechildhood.Giventhatthetraits
of neuroticism, agreeableness, and conscientiousness are in-
dependent of each other (Costa et al., 2000; Costa & McCrae,
1992),theassociationsbetweenthesetraitsinparentsandtheir
offspring’s interpersonal functioning in late adolescence–
early adulthood may reflect different developmental trajecto-
riesleadingtothesameoutcome,aconceptknownas“equifin-
ality” (Cicchetti & Toth, 1995). The association between high
neuroticism in parents and offspring internalizing problems in
middle childhood and poor interpersonal functioning in late
adolescence–early adulthood is consistent with findings from
studies of the offspring of parents with major depression,
which show evidence of an intergenerational transmission of
internalizing problems (Hammen, Shih et al., 2004; Rutter,
2004; Weissman et al., 2006). Thus, poor interpersonal func-
tioning among offspring in late adolescence–early adulthood
maysignal anincreasedriskfor major depression.By contrast,
the association between parents’ high neuroticism and low
agreeableness and offspring externalizing problems in middle
childhood may represent a different pathway to poor interper-
sonal functioning among offspring in late adolescence–early
adulthood. High neuroticism and low agreeableness both con-
tribute to trait anger, with the former being associated with an-
gryaffectandthelatterwiththecontrolofaggressiveresponses
(Martin, Watson, & Wan, 2000). Perhaps this developmental
trajectory incorporates the transmission of anger and reactive
aggression from parents to offspring, reflected in the external-
izingproblemsinmiddlechildhoodandimpairedinterpersonal
functioning in late adolescence–early adulthood. In a similar
fashion, maternal negativity in childhood predicted poor ex-
ecutive functioning and the subsequent development of BD
in young adulthood among the offspring of parents with an af-
fective disorder (Meyeret al., 2006). Thus, parental agreeable-
ness may highlight a unique developmental trajectory to poor
interpersonal functioning and psychopathology in late adoles-
cence–early adulthood.
At least three, not mutually exclusive mechanisms of
transmission could account for the associations observed be-
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
582

Page 11

tween parents’ personality traits and outcomes among off-
spring. First, genes may partly explain the observed associa-
tions. There is evidence that the big five personality traits are
determined, in part, by genetic factors (Bouchard & Loehlin,
2001; Loehlin, 1992). In addition, levels of neuroticism are
elevated in the healthy first-degree relatives of people with
major depression (Maier, Minges, Lichtermann, Franke, &
Gansicke, 1995), suggesting that one facet of the genetic vul-
nerability for affective disorders may be expressed as the
trait of neuroticism. Indeed, biometric modelling studies of
twin populations have suggested that the same genes contrib-
utetoneuroticism and depression(Fanous, Gardner,Prescott,
Cancro, & Kendler, 2002; Hettema et al., 2006; Kendler
et al., 2006). Therefore, a child who inherits the genes asso-
ciated with affective disorders may also inherit a tendency
to react emotionally to stressors and daily problems (Van
Os & Jones, 1999), which in turn might impede the develop-
ment of interpersonal skills and meaningful interpersonal re-
lationships. Although less is known about the association be-
tween agreeableness and affective disorders (Meyer et al.,
2006), one study reported that patients with BD have low
levels of this trait (Lozano & Johnson, 2001) and other stud-
ieshaveshownthatlowlevelsofagreeablenessinadolescents
were associated with externalizing problems (Miller, Lynam,
& Jones, 2008; Pursell, Laursen, Rubin, Booth-Laforce, &
Rose-Krasnor, 2008). Thus, the child who inherits genes as-
sociated with low agreeableness may exhibit externalizing
problems that in turn would increase rejection by peers and
social dysfunction.
Second, a mechanism by which parents’ personality may
affect offspring outcomes is modeling. Individuals high in
neuroticism experience a host of negative emotions, generate
stressful life events, and exhibit poor skills for coping with
stress (Belsky & Barends, 2002; DeLongis & Holtzman,
2005; Ellenbogen & Hodgins, 2004; Watson et al., 2005).
Likewise, individuals low on agreeableness tend to be angry,
manipulative, and competitive, and to resolve conflicts using
coercive tactics (Jensen-Campbell & Graziano, 2001; Kup-
pens, 2005). Thus, parents with high levels of neuroticism
and low levels of agreeableness may model maladaptive
and dysfunctional behaviors that influence their offspring’s
socialdevelopmentandabilitiesforcopingwithstress(Brook
et al., 2002; Compas, Connor-Smith, & Jaser, 2004; Degnan
et al., 2008; Ellenbogen & Hodgins, 2004). The offspring’s
difficulties may further enhance their vulnerability for affec-
tive disorders.
Third, as has been suggested in Belsky’s (1984) process
model of parenting, the association between parents’ person-
ality and offspring outcomes may result from poor parenting
practices and disruptions in the parent–child relationship.
High neuroticism in parents, relative to low neuroticism,
has been associated with a parenting style that is less warm
and responsive, and more inconsistent, disorganized, and in-
trusive (Belsky et al., 1995; Clark et al., 2000; Ellenbogen &
Hodgins,2004;Kochanskaetal.,1997).Fewstudieshaveex-
amined the association between agreeableness and parenting
style, but those that have found high agreeableness to predict
positive affect and less controlling behaviors (Belsky et al.,
1995; Losoya, Callor, Rowe, & Goldsmith, 1997), and low
agreeableness to predict less responsive parenting (Clark
et al., 2000; Kochanska et al., 1997). Thus, parents’ person-
ality and the associated parenting behaviors may negatively
affect family functioning and parent–child interactions,
which in turn increase the likelihood of problem behaviors
and poor interpersonal functioning in the offspring similar
to those presented by their parents (Elder et al., 1986).
Among adolescents and young adults, deficits in interper-
sonal functioning are associated with the development of ma-
jor depression (Davila, Hammen, Burge, Paley, & Daley,
1995; Eberhart & Hammen, 2006; Hammen, Shih, et al.,
2004). Consequently, understanding the mechanisms leading
to poor psychosocial functioning will contribute to clarify-
ing the etiology of depression. Individuals presenting poor
interpersonal functioning have difficulty establishing and
maintaining relationships with friends, colleagues, roman-
tic partners, and family members. They often suffer from
loneliness, lack social support, and demonstrate poor skills
in resolving conflicts (Cacioppo et al., 2008; Cattan, Newell,
Bond, & White, 2003; Eberhart & Hammen, 2006; Hammen,
Shih et al., 2004; Heinrich & Gullone, 2006). An understand-
ing of the mechanisms involved in the emergence of affective
disorders is essential to establishing successful prevention
programs, especially in children at elevated genetic risk for
these disorders (Beardslee & Gladstone, 2001; Garber
etal.,2009).Evidencefromthepresentstudysuggeststhatin-
terpersonal functioning may be a relevant target for such in-
terventions among high-risk children before behavioral prob-
lems emerge.
The finding that parents’ level of neuroticism was more
strongly predictive of offspring internalizing problems in
middle childhood among families with a parent having BD,
relative to families with no affective disorders, suggests that
the OBD are more sensitive to the consequences of their par-
ents’ high levels of neuroticism than the ONMD. It is reason-
able to assume that the subgroup of OBD who will develop
major affective disorders in adulthood will have inherited a
tendency for high levels of neuroticism (Kendler et al.,
2004, 2006). This tendency to overreact behaviorally and
emotionally would make these offspring more sensitive to
the negative consequences of their parents’ high levels of
neuroticism such as creating a chaotic, unstructured, and
stressful family environment (Chang et al., 2001; Ellenbogen
& Hodgins, 2004; Romero, Delbello, Soutullo, Stanford, &
Strakowski, 2005). This family environment, coupled with
parental modeling of inadequate skills for coping with stress,
maylead tothe internalizing problems (Birmaheret al., 2010;
Giles, DelBello, Stanford, & Strakowski, 2007) and HPA hy-
peractivity (Ellenbogen & Hodgins, 2009; Ellenbogen et al.,
2010) that has been observed among the OBD in childhood
and adolescence. Increased childhood internalizing prob-
lems, in turn, increase the risk of poor interpersonal function-
ing in late adolescence–early adulthood, which ultimately in-
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
583

Page 12

creases the risk of developing an affective disorder (Hammen
et al.,2003). Thus,these hypothesized environmentalmecha-
nisms, compounded by changes to the HPA axis, may en-
hance an inherited predisposition among the subgroup of off-
spring who will later develop affective disorders to react
emotionally to stressors and daily hassles from an early age.
The strengths of this study include an intergenerational
longitudinal design, a unique sample of parents with BD
and their offspring, diagnostic interviews conducted on all
parents and offspring, and high interrater reliability for diag-
noses and for ratings of offspring functioning in late adoles-
cence–earlyadulthood. Some limitations of the study warrant
discussion. The sample may not have been large enough to
detect effect sizesofsmallmagnitude, and therefore,negative
findings should be interpreted with caution. Caution should
also be used when interpreting borderline significant results
and the moderated mediation analyses. Moreover, the inclu-
sion of siblings transgresses the independence of cases as-
sumption. The findings were replicated, however, in a sub-
sample that included only one child per family, suggesting
that the present results are not due to alpha inflation associ-
ated with the nonindependent data. It is also possible that
the results may be confounded bya reporting bias; parents re-
ported on their own personality and offspring’s behavioral
problems. Studies of reporting biases associated with mood
disorders have been inconclusive, with some studies showing
bias (e.g., Weisz, Rudolph, Granger, & Sweeney, 1992) and
others no bias (e.g., Richters, 1992). To attempt to counter
any such possible bias, parents completed both measures
when euthymic and mean scores from two parents for both
their own personality and their child’s behavior were used
in the majority of cases. No reporting bias was associated
with the outcome measure, offspring’s interpersonal function-
ing in late adolescence–early adulthood. It is also possible
that a variable not measured in the study was responsible for
thepresentresults.Asthestudyfocusedontheoffspringofpar-
entswith BD, the extent towhich theresultsgeneralizetoother
samplescan only be determinedby future research.Finally, the
offspringrangedinagefrom15to27yearsold.Althoughthere
were no significant differences on scores for functioning in any
oftheinterpersonaldomainsbetweentheoffspringaged15and
18 years (n ¼ 47) and thoseaged 19 and 27 years (n ¼ 77),the
younger offspring presented more problems at school, F (1,
110) ¼ 4.85, p , .05, and fewer financial problems, F (1,
122) ¼ 8.48, p , .01, than the older offspring.
To conclude, the present studyshowed that parents’ person-
alitytraitsmaybeassociatedwiththeinitiationofamaladaptive
developmental trajectory toward affective disorders among
some of their offspring. Future work in this area should focus
on understanding the mechanisms at play, such as the role of
specificgeneticpolymorphismsassociatedwithaffectivedisor-
ders (Gotlib, Joormann, Minor, & Hallmayer, 2008) and gene–
environment interplay (Rutter, Moffitt, et al., 2006; Taylor
et al., 2006). In the meantime, the present study has shown
that high levels of neuroticism and low levels of agreeableness
among parents predict poor interpersonal functioning among
their offspring in late adolescence–early adulthood, that these
associationsaremediatedbyoffspring’sinternalizingandexter-
nalizing problems in middle childhood, and that the mediation
may be stronger in families in which a parent has BD.
References
Achenbach,T.M.(1991).ManualfortheChildBehaviorChecklist/4–18and
1991profile.Burlington,VT:UniversityofVermont,DepartmentofPsy-
chiatry.
Adrian, C., & Hammen, C. (1993). Stress exposure and stress generation in
children of depressed mothers. Journal of Consulting and Clinical Psy-
chology, 61, 354–359.
AmericanPsychiatric Association. (1994). Diagnostic and statistical manual
of mental disorders (4th ed.). Washington DC: Author.
Anderson, C. A., & Hammen, C. L. (1993). Psychosocial outcomes of chil-
dren of unipolar depressed, bipolar, medically ill, and normal women: A
longitudinal study. Journal of Consulting and Clinical Psychology, 61,
448–454.
Bagby, R. M., Bindseil, K. D., Schuller, D. R., & Rector, N. A. (1997). Re-
lationship between the five-factor model of personality and unipolar, bi-
polar and schizophrenic patients. Psychiatry Research, 70, 83–94.
Barkley, R.A.(1988).Childbehaviorratingscalesand checklists.In M.Rut-
ter & A. H. Tuma (Eds.), Assessment and diagnosis in child psychopa-
thology (pp. 113–155). New York: Guilford Press.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable dis-
tinctioninsocialpsychologicalresearch:Conceptual,strategic,andstatis-
tical considerations. Journal of Personality and Social Psychology, 51,
1173–1182.
Beardslee,W.R.,&Gladstone,T.R.(2001).Preventionofchildhooddepres-
sion: Recent findings and future prospects. Biological Psychiatry, 49,
1101–1110.
Belsky,J.(1984).Thedeterminantsofparenting:Aprocessmodel.ChildDe-
velopment, 55, 83–96.
Belsky, J., & Barends, N. (2002). Personality and parenting handbook of
parenting: Vol. 3. Being and becoming a parent (2nd ed., pp. 415–
438). Mahwah, NJ: Erlbaum.
Belsky, J., Crnic, K., & Woodworth, S. (1995). Personality and parenting:
Exploringthemediatingroleoftransientmoodanddailyhassles.Journal
of Personality, 63, 905–929.
Birmaher, B., Axelson, D., Goldstein, B., Monk, K., Kalas, C., Obreja, M.,
et al. (2010). Psychiatric disorders in preschool offspring of parents
with bipolar disorder: The Pittsburgh Bipolar Offspring Study (BIOS).
American Journal of Psychiatry, 167, 321–330.
Birmaher, B., Axelson, D., Monk, K., Kalas, C., Goldstein, B., Hickey, M.
B., et al. (2009). Lifetime psychiatric disorders in school-aged offspring
of parents with bipolar disorder: The Pittsburgh Bipolar Offspring study.
Archives of General Psychiatry, 66, 287–296.
Bouchard, T. J., Jr., & Loehlin, J. C. (2001). Genes, evolution, and person-
ality. Behavior Genetics, 31, 243–273.
Broidy, L. M., Nagin, D. S., Tremblay, R. E., Bates, J. E., Brame, B., Dodge,
K. A., et al. (2003). Developmental trajectories of childhood disruptive
behaviors and adolescent delinquency: A six-site, cross-national study.
Developmental Psychology, 39, 222–245.
Brook, J. S., Whiteman, M., & Zheng, L. (2002). Intergenerational transmis-
sion of risks for problem behavior. Journal of Abnormal Child Psychol-
ogy, 30, 65–76.
Cacioppo, J. T., Hawkley, L. C., Kalil, A., Hughes, M. E., Waite, L., & This-
ted, R. A. (2008). Happiness and the invisible threads of social connec-
tion: The Chicago Health, Aging, ansd Social Relations Study. In M. Eid
& R. Larsen (Eds.), The science of well-being (pp. 195–219). New York:
Guilford Press.
Carlson, G. A., Bromet, E. J., & Sievers, S. (2000). Phenomenologyand out-
come of subjects with early- and adult-onset psychotic mania. American
Journal of Psychiatry, 157, 213–219.
Caspi, A., Moffitt, T. E., Newman, D. L., & Silva, P. A. (1996). Behavioral
observations at age 3 years predict adult psychiatric disorders. Longitudinal
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
584

Page 13

evidence from a birth cohort. Archives of General Psychiatry, 53, 1033–
1039.
Cattan, M., Newell, C., Bond, J., & White, M. (2003). Alleviating social iso-
lation and loneliness among older people. International Journal of Men-
tal Health Promotion, 5, 20–30.
Chang, K. D., Blasey, C., Ketter, T. A., & Steiner, H. (2001). Family envi-
ronment of children and adolescents with bipolar parents. Bipolar Disor-
ders, 3, 73–78.
Cicchetti,D.,&Toth,S.L.(1995).Developmentalpsychopathologyanddis-
orders of affect. In D. Cicchetti & D. Cohen (Eds.), Developmental psy-
chopathology: Vol. 2. Risk, disorder, and adaptation (pp. 369–420).
New York: Wiley.
Cicchetti, D., & Toth, S. L. (1998). The development of depression in chil-
dren and adolescents. American Psychologist, 53, 221–241.
Clark, L. A., Kochanska, G., & Ready, R. (2000). Mothers’ personality and
its interaction with child temperament as predictors of parenting behav-
ior. Journal of Personality and Social Psychology, 79, 274–285.
Compas, B. E., Connor-Smith, J., & Jaser, S. S. (2004). Temperament, stress
reactivity, and coping: Implications for depression in childhood and ado-
lescence. Journal of Clinical Child and Adolescent Psychology, 33, 21–
31.
Conger, R. D., Conger, K. J., Elder, G. H., & Lorenz, F. O. (1992). A family
process model of economic hardship and adjustment of early adolescent
boys. Child Development, 63, 526–541.
Costa, P. T., Herbst, J. H., McCrae, R. R., & Siegler, I. C. (2000). Personality
at midlife: Stability, intrinsic maturation, and response to life events. As-
sessment, 7, 365–378.
Costa, P. T., & McCrae, R. R. (1992). Revised NEO Personality Inventory
(NEO PI-R): Professional manual. Odessa, FL: Psychological Assess-
ment Resources.
Davila, J., Hammen, C., Burge, D., Paley, B., & Daley, S. E. (1995). Poor
interpersonal problem solving as a mechanism of stress generation in de-
pression among adolescent women. Journal of Abnormal Psychology,
104, 592–600.
Degnan, K., Henderson, H., Fox, N., & Rubin, K. (2008). Predicting social
wariness in middle childhood: The moderating roles of childcare history,
maternal personality and maternal behavior. Social Development, 17,
471–487.
DeLongis, A., & Holtzman, S. (2005). Coping in context: The role of stress,
social support, and personality in coping. Journal of Personality, 73,
1633–1656.
Derryberry,D.,&Rothbart,M.K.(1997).Reactiveandeffortfulprocessesin
the organization of temperament. Development and Psychopathology, 9,
633–652.
Duffy, A., Alda, M., Hajek, T., Sherry, S. B., & Grof, P. (2010). Early stages
in the development of bipolar disorder. Journal of Affective Disorders,
121, 127–135.
Eberhart, N. K., & Hammen, C. L. (2006). Interpersonal predictors of onset
of depression during the transition to adulthood. Personal Relationships,
13, 195–206.
Elder, G., Caspi, A., & Downey, G. (1986). Problem behavior and family re-
lationships: Life course and intergenerational themes. In A. B. Sørensen,
F. E. Weinert, & L. R. Sherrod (Eds.), Human development and the
life course: Multidisciplinary perspectives (pp. 293–340). Hillsdale,
NJ: Erlbaum.
Elgar, F. J., Mills, R. S., McGrath, P. J., Waschbusch, D. A., & Brownridge,
D. A. (2007). Maternal and paternal depressive symptoms and child mal-
adjustment: The mediating role of parental behavior. Journal of Abnor-
mal Child Psychology, 35, 943–955.
Ellenbogen, M. A., & Hodgins, S. (2004). The impact of high neuroticism
in parents on children’s psychosocial functioning in a population at
high risk for major affective disorder: A family–environmental pathway
of intergenerational risk. Development and Psychopathology, 16, 113–
136.
Ellenbogen, M. A., & Hodgins, S. (2009). Structure provided by parents in
middle childhood predicts cortisol reactivity in adolescence among the
offspring of parents with bipolar disorder and controls. Psychoneuroen-
docrinology, 34, 773–785.
Ellenbogen, M. A., Hodgins, S., Walker, C. D., Couture, S., & Adam, S.
(2006). Daytime cortisol and stress reactivity in the offspring of parents
with bipolar disorder. Psychoneuroendocrinology, 31, 1164–1180.
Ellenbogen,M.A.,Santo,J.B.,Linnen,A. M.,Walker, C.D.,& Hodgins,S.
(2010). High cortisol levels in the offspring of parents with bipolar dis-
order during twoweeks of dailysampling.Bipolar Disorders, 12, 77–86.
Fanous, A., Gardner, C. O., Prescott, C. A., Cancro, R., & Kendler, K. S.
(2002). Neuroticism, major depression and gender: A population-based
twin study. Psychological Medicine, 32, 719–728.
Fanous, A., Neale, M. C., Aggen, S. H., & Kendler, K. S. (2007). A longitu-
dinal study of personality and major depression in a population-based
sample of male twins. Psychological Medicine, 37, 1163–1172.
Field, T. M. (2002). Prenatal effects of maternal depression. In S. H. Good-
man & I. H. Gotlib (Eds.), Children of depressed parents: Mechanisms
of risk and implications for treatment (pp. 59–88). Washington, DC:
American Psychological Association.
First, M. B., Gibbon, M., Spitzer, R. L., & Williams, J. B. (2002). Structured
clinical interview for the DSM-IV-TR axis I disorders, research version,
patienteditionwithpsychoticscreen.NewYork:NewYorkStatePsychi-
atric Institute, Biometrics Research.
Garber, J., Clarke, G. N., Weersing, V. R., Beardslee, W. R., Brent, D. A.,
Gladstone, T. R., et al. (2009). Prevention of depression in at-risk adoles-
cents: A randomized controlled trial. Journal of the American Medical
Association, 301, 2215–2224.
Giles, L. L., DelBello, M. P., Stanford, K. E., & Strakowski, S. M. (2007).
Child behavior checklist profiles of children and adolescents with and
athighrisk fordevelopingbipolardisorder.ChildPsychiatryandHuman
Development, 38, 47–55.
Goldstein, B. I., Shamseddeen, W., Axelson, D. A., Kalas, C., Monk, K.,
Brent, D. A., et al. (2010). Clinical, demographic, and familial correlates
of bipolar spectrum disorders among offspring of parents with bipolar
disorder. Journal of the American Academy of Child & Adolescent Psy-
chiatry, 49, 388–396.
Goodman,S.H.,&Gotlib,I.H.(1999).Riskforpsychopathologyinthechil-
dren of depressed mothers: A developmental model for understanding
mechanisms of transmission. Psychological Review, 106, 458–490.
Goodwin, R. D., Fergusson, D. M., & Horwood, L. J. (2004). Earlyanxious/
withdrawn behaviours predict later internalising disorders. Journal of
Child Psychology and Psychiatry, 45, 874–883.
Gotlib, I. H., Joormann, J., Minor, K. L., & Hallmayer, J. (2008). HPA axis
reactivity: A mechanism underlying the associations among 5-HTTLPR,
stress, and depression. Biological Psychiatry, 63, 847–851.
Gotlib,I.H.,Traill,S.K.,Montoya,R.L.,Joormann,J.,&Chang,K.(2005).
Attention and memory biases in the offspring of parents with bipolar dis-
order: Indications from a pilot study. Journal of Child Psychology and
Psychiatry, 46, 84–93.
Halligan,S.L.,Herbert,J.,Goodyer,I.M.,&Murray,L.(2004).Exposureto
postnataldepressionpredictselevatedcortisolinadolescentoffspring.Bi-
ological Psychiatry, 55, 376–381.
Hammen, C. (1991). Depression runs in families: The social context of risk
and resilience in children of depressed mothers. New York: Springer–
Verlag.
Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psy-
chology, 1, 293–319.
Hammen, C., Brennan, P. A., & Shih, J. H. (2004). Family discord and stress
predictors of depression and other disorders in adolescent children of de-
pressed and nondepressed women. Journal of the American Academy of
Child & Adolescent Psychiatry, 43, 994–1002.
Hammen,C.,Shih,J.,Altman,T.,&Brennan,P.A.(2003).Interpersonalim-
pairment and the prediction of depressive symptoms in adolescent chil-
dren of depressed and nondepressed mothers. Journal of the American
Academy of Child & Adolescent Psychiatry, 42, 571–577.
Hammen, C., Shih, J. H., & Brennan, P. A. (2004). Intergenerational transmis-
sion of depression: Test of an interpersonal stress model in a community
sample. Journal of Consulting and Clinical Psychology, 72, 511–522.
Heinrich, L. M., & Gullone, E. (2006). The clinical significance of loneli-
ness: A literature review. Clinical Psychology Review, 26, 695–718.
Hettema, J. M., Neale, M. C., Myers, J. M., Prescott, C. A., & Kendler, K. S.
(2006). A population-based twin study of the relationship between neu-
roticism and internalizing disorders. American Journal of Psychiatry,
163, 857–864.
Hodgins, S., Faucher, B., Zarac, A., & Ellenbogen, M. (2002). Children of
parentswithbipolardisorder.Apopulationathighriskformajoraffective
disorders. Child and Adolescent Psychiatric Clinics of North America,
11, 533–553, ix.
Jensen-Campbell, L.A.,&Graziano,W.G. (2001).Agreeablenessasa mod-
erator of interpersonal conflict. Journal of Personality, 69, 323–362.
Jones, N. A., Field, T., Fox, N. A., Lundy, B., & Davalos, M. (1997). EEG
activationin1-month-oldinfantsofdepressedmothers.Developmentand
Psychopathology, 9, 491–505.
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
585

Page 14

Joormann, J., Talbot, L., & Gotlib, I. H. (2007). Biased processing of emo-
tional information in girls at risk for depression. Journal of Abnormal
Psychology, 116, 135–143.
Kaufman,J.,Birmaher,B.,Brent,D.,&Rao, U.(1997).ScheduleforAffective
Disorders and Schizophrenia for School-Age Children—Present and life-
time version (K-SADS-PL): Initial reliability and validity data. Journal of
the American Academy of Child & Adolescent Psychiatry, 36, 980–988.
Kaufman, J., Schweder, A. E., Hilsenroth, M. J., & Segal, D. L. (2004).
The Schedule for Affective Disorders and Schizophrenia for School-
Age Children: Present and lifetime version (K-SADS-PL). Hoboken,
NJ: Wiley.
Kendler, K. S., Gatz, M., Gardner, C. O., & Pedersen, N. L. (2006). Person-
ality and major depression: A Swedish longitudinal, population-based
twin study. Archives of General Psychiatry, 63, 1113–1120.
Kendler, K. S., Kuhn, J., & Prescott, C. A. (2004). The interrelationship of
neuroticism, sex, and stressful life events in the prediction of episodes
of major depression. American Journal of Psychiatry, 161, 631–636.
Klein, D. N., Durbin,E., Shankman, S. A., & Santiago, N. J. (2002). Depres-
sion and personality. In I. H. Gotlib & C. Hammen (Eds.), Handbook of
depression (pp. 115–140). New York: Guilford Press.
Klimes-Dougan, B., Ronsaville, D., Wiggs, E. A., & Martinez, P. E. (2006).
Neuropsychological functioning in adolescent children of mothers with a
history of bipolar or major depressive disorders. Biological Psychiatry,
60, 957–965.
Kochanska, G., Clark, L. A., & Goldman, M. S. (1997). Implications of
mothers’ personality for their parenting and their young children’s devel-
opment outcomes. Journal of Personality, 65, 387–420.
Kuppens,P.(2005).Interpersonaldeterminantsoftraitanger:Lowagreeable-
ness, perceived low social esteem, and the amplifying role of the impor-
tance attached to social relationships. Personality and Individual Differ-
ences, 38, 13–23.
Kurdek, L. A. (2003). Correlates of parents’ perceptions of behavioral prob-
lems in theiryoung children. Journalof Applied DevelopmentalPsychol-
ogy, 24, 457–473.
Lapalme, M., Hodgins, S., & LaRoche, C. (1997). Children of parents with
bipolar disorder: A metaanalysis of risk for mental disorders. Canadian
Journal of Psychiatry, 42, 623–631.
LaRoche,C.(1985).Psychopathologyintheoffspringofparentswithbipolar
affective disorders. Canadian Journal of Psychiatry 30, 337–343.
Laursen, B., & Collins, W. A. (1994). Interpersonal conflict during adoles-
cence. Psychological Bulletin, 115, 197–209.
Loehlin, J. C. (1992). Genes and environment in personality development.
Thousand Oaks, CA: Sage.
Losoya,S.H.,Callor,S.,Rowe,D.C.,&Goldsmith,H.H.(1997).Originsof
familial similarity in parenting: A study of twins and adoptive siblings.
Developmental Psychology, 33, 1012–1023.
Lozano, B. E., & Johnson, S. L. (2001). Can personality traits predict in-
creases in manic and depressive symptoms? Journal of Affective Disor-
ders, 63, 103–111.
MacKinnon,D.P., Lockwood, C.M.,Hoffman,J.M., West, S.G.,& Sheets,
V.(2002).A comparisonofmethodsto testmediationandotherinterven-
ing variable effects. Psychological Methods, 7, 83–104.
Maier, W., Minges, J., Lichtermann, D., Franke, P., & Gansicke, M. (1995).
Personality patterns in subjects at risk for affective disorders. Psychopa-
thology, 28(Suppl. 1), 59–72.
Martin, R., Watson, D., & Wan, C. K. (2000). A three-factor model of trait
anger: Dimensions of affect, behavior, and cognition. Journal of Person-
ality, 68, 869–897.
Meyer, S.E., Carlson,G. A.,Wiggs,E.A.,Ronsaville,D. S., Martinez,P. E.,
Klimes-Dougan,B.,et al.(2006).Aprospectivehigh-riskstudyoftheas-
sociation among maternal negativity, apparent frontal lobe dysfunction,
and the development of bipolar disorder. Development and Psychopa-
thology, 18, 573–589.
Miller, J. D., Lynam, D. R., & Jones, S. (2008). Externalizing behavior
through the lens of the five-factor model: A focus on agreeableness
and conscientiousness. Journal of Personality Assessment, 90, 158–164.
Muller, D., Judd, C. M., & Yzerbyt, V. Y. (2005). When moderation is medi-
ated and mediation is moderated. Journal of Personality and Social Psy-
chology, 89, 852–863.
Murray, L., Fiori-Cowley, A., Hooper, R., & Cooper, P. (1996). The impact
of postnatal depression and associated adversity on early mother–infant
interactions and later infant outcomes. Child Development, 67, 2512–
2526.
Newman, D. L., Caspi, A., Moffitt, T. E., & Silva, P. A. (1997). Antecedents
ofadultinterpersonalfunctioning:Effectsofindividualdifferencesinage
3 temperament. Developmental Psychology, 33, 206–217.
Ostiguy, C. S., Ellenbogen, M. A., Linnen, A. M., Walker, E. F., Hammen,
C., & Hodgins, S. (2009). Chronic stress and stressful life events in the
offspringofparentswithbipolardisorder.JournalofAffectiveDisorders,
114, 74–84.
Prinzie, P., Stams, G. J., Dekovic, M., Reijntjes, A. H., & Belsky, J. (2009).
The relations between parents’ Big Five personality factors and parent-
ing: A meta-analytic review. Journal of Personality and Social Psychol-
ogy, 97, 351–362.
Pursell, G. R., Laursen, B., Rubin, K. H., Booth-Laforce, C., & Rose-Kras-
nor,L.(2008).Genderdifferencesin patterns ofassociationbetweenpro-
social behavior, personality, and externalizing problems. Journal of Re-
search in Personality, 42, 472–481.
Radke-Yarrow, M., Nottelmann, E., Martinez, P., & Fox, M. B. (1992).
Young children of affectively ill parents: A longitudinal studyof psycho-
social development. Journal of the American Academy of Child & Ado-
lescent Psychiatry, 31, 68–77.
Ramirez Basco, M., Bostic, J. Q., Davies, D., Rush, A. J., Witte, B., Hen-
drickse, W., et al. (2000). Methods to improve diagnostic accuracy in a
community mental health setting. American Journal of Psychiatry,
157, 1599–1605.
Richters, J. E. (1992). Depressed mothers as informants about their children:
A critical review of the evidence for distortion. Psychological Bulletin,
112, 485–499.
Rolland, J. P., Parker, W. D., & Stumpf, H. (1998). A psychometric exami-
nation oftheFrenchtranslations ofthe NEO-PI-R and NEO-FFI. Journal
of Personality Assessment, 71, 269–291.
Romero, S., Delbello, M. P., Soutullo, C. A., Stanford, K., & Strakowski, S.
M. (2005). Family environment in families with versus families without
parental bipolar disorder: A preliminary comparison study. Bipolar Dis-
orders, 7, 617–622.
Rudolph, K. D., Hammen, C., Burge, D., Lindberg, N., Herzberg, D., & Da-
ley,S.E.(2000).Towardaninterpersonallife-stressmodelofdepression:
The developmental context of stress generation. Development and Psy-
chopathology, 12, 215–234.
Rutter, M. (2004). Intergenerational continuities and discontinuities in psy-
chological problems. In P. L. Chase-Lansdale, K. Kiernan, & R. J. Fried-
man (Eds.), Human development across lives and generations: The po-
tential for change (pp. 239–277). New York: Cambridge University
Press.
Rutter, M. (2007). Gene–environment interdependence. Developmental Sci-
ence, 10, 12–18.
Rutter, M., Kim-Cohen, J., & Maughan, B. (2006). Continuities and discon-
tinuitiesin psychopathologybetweenchildhoodandadultlife.Journalof
Child Psychology and Psychiatry, 47, 276–295.
Rutter, M., Moffitt, T. E., & Caspi, A. (2006). Gene–environment interplay
andpsychopathology:Multiplevarietiesbutrealeffects.JournalofChild
Psychology and Psychiatry, 47, 226–261.
Shih, J. H., Eberhart, N. K., Hammen, C. L., & Brennan, P. A. (2006). Dif-
ferential exposure and reactivity to interpersonal stress predict sex differ-
ences in adolescentdepression.Journal of Clinical Child and Adolescent
Psychology, 35, 103–115.
Shiner, R. L., Masten, A. S., & Roberts, J. M. (2003). Childhood personality
foreshadows adult personalityand life outcomestwo decades later. Jour-
nal of Personality, 71, 1145–1170.
Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The Struc-
tured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and
description. Archives of General Psychiatry, 49, 624–629.
Sullivan, S. A. (1997). Maternal neuroticism as a moderator of behavior
problems in preschool children. Doctoral dissertation (AAT 9807135),
ProQuest Information & Learning database.
Taylor, S. E., Way, B. M., Welch, W. T., Hilmert, C. J., Lehman, B. J., & Ei-
senberger, N. I. (2006). Early family environment, current adversity, the
serotonin transporter promoter polymorphism, and depressive symptom-
atology. Biological Psychiatry, 60, 671–676.
Van Os, J., & Jones, P. B. (1999). Early risk factors and adult person–envi-
ronment relationships in affective disorder. Psychological Medicine, 29,
1055–1067.
Watson, D., Gamez, W., & Simms, L. J. (2005). Basic dimensions of tem-
perament and their relation to anxiety and depression: A symptom-based
perspective. Journal of Research in Personality, 39, 46–66.
C. S. Ostiguy, M. A. Ellenbogen, and S. Hodgins
586

Page 15

Weissman,M.M., Warner,V., Wickramaratne, P., Moreau,D.,& Olfson,M.
(1997). Offspring of depressed parents: 10 years later. Archives of Gen-
eral Psychiatry, 54, 932–940.
Weissman,M.M.,Wickramaratne,P.,Nomura,Y.,Warner,V.,Pilowsky,D.,
& Verdeli, H. (2006). Offspring of depressed parents: 20 years later.
American Journal of Psychiatry, 163, 1001–1008.
Weisz, J. R., Rudolph, K. D., Granger, D. A., & Sweeney, L. (1992). Cogni-
tion, competence, and coping in child and adolescent depression: Re-
search findings, developmental concerns, therapeutic implications. De-
velopment and Psychopathology, 4, 627–653.
Widiger, T. A., & Trull, T. J. (1992). Personality and psychopathology: An
applicationofthefive-factormodel.JournalofPersonality,60,363–393.
Zanarini, M. C., & Frankenburg, F. R. (2001). Attainment and maintenance
of reliability of Axis I and II disorders over the course of a longitudinal
study. Comprehensive Psychiatry, 42, 369–374.
Zaslow,M.J. (1985).Depressedmoodinnew fathers:Associationswithpar-
ent–infant interaction. Genetic, Social, and General Psychology Mono-
graphs, 111, 133–150.
Personality of parents with bipolar disorder and interpersonal functioning among their offspring
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