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    Rights statement: The final, definitive version of this article has been published in the Journal, The Australian & New Zealand Journal of Psychiatry, ? (?), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the The Australian & New Zealand Journal of Psychiatry page: http://journals.sagepub.com/home/anpon SAGE Journals Online: http://journals.sagepub.com/

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

Research output: Contribution to Journal/MagazineJournal articlepeer-review

E-pub ahead of print
<mark>Journal publication date</mark>14/03/2018
<mark>Journal</mark>Australian and New Zealand Journal of Psychiatry
Publication StatusE-pub ahead of print
Early online date14/03/18
<mark>Original language</mark>English


Objectives: This study investigated whether there were differences in coping strategies and self-esteem between offspring of parents with bipolar disorder (high-risk) and offspring of unaffected parents (control), and whether these psychological factors predicted the onset and recurrence of mood episodes. Methods: High-risk and control offspring were followed longitudinally as part of the Flourish Canadian high-risk bipolar offspring cohort study. Offspring were clinically assessed annually by a psychiatrist using semi-structured interviews and completed a measure of coping strategies and self-esteem. Results: In high-risk offspring, avoidant coping strategies significantly increased the hazard of a new onset Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised mood episode or recurrence (hazard ratio: 1.89, p = 0.04), while higher self-esteem significantly decreased this hazard (hazard ratio: 2.50, p < 0.01). Self-esteem and avoidant coping significantly interacted with one another (p < 0.05), where the risk of a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised new onset mood episode or recurrence was only significantly increased among high-risk offspring with both high avoidant coping and low self-esteem. Conclusion: A reduction of avoidant coping strategies in response to stress and improvement of self-esteem may be useful intervention targets for preventing the new onset or recurrence of a clinically significant mood disorder among individuals at high familial risk.