Children of parents with a mental illness – Starting points and barriers in the implementation of preventive measures
Abstract
Children and adolescents growing up with a parent with a mental illness are at an increased risk of developing a mental illness themselves over the course of their lives. Although specific preventive interventions for affected children and adolescents show small to medium significant effects, so far, these have not been standardly implemented in clinical practice. Thus, the initial aim of this dissertation is to establish relevant starting points for preventive interventions at the parental level. Furthermore, barriers to the implementation of preventive interventions are to be identified, and finally, measures to sustainably improve preventive care for these children and adolescents are to be derived.
The first study examines the association of parental and child mental health problems during the COVID-19 pandemic. In line with pre-pandemic results, meta-analyses revealed small to medium significant effects, with the largest effects for the association between parenting stress and children’s mental health outcomes. The results highlight that fostering parenting skills to reduce parenting stress and to promote child development should be a central component of preventive interventions for children and adolescents growing up with a parent with a mental illness.
The study protocol for the multicenter, randomized-controlled clinical trial “Children of Mentally ill Parents At Risk Evaluation“ (COMPARE-family) is presented in the second study. COMPARE-family examines the preventive effects of cognitive behavioral therapy (CBT) alone, with those of CBT and an additional parenting training (CBT + Triple P), for parents with a mental illness on the mental health of their children.
The third study summarizes experiences from four large European research projects on children of parents with a mental illness (COMPARE-family, VIA-family, The Village, and ProChild). On this basis, recommendations for planning and implementing preventive measures for families affected by a parental mental illness are derived. These recommendations focus on study participation, access and coordination of services, stigma towards mental health, sustainability of prevention and intervention programs, and unforeseen events.
The “Children of Parents with a Mental Illness-Stigma Questionnaire” (COPMI-SQ) was piloted, validated, and adapted in the fourth and fifth studies. The COPMI-SQ-r comprises twelve items to assess the specific experiences of stigma by association in adolescents affected by a parental mental illness on the dimensions 1) “Experienced Stigma by Association”, 2) “Affiliate Stigma”, 3) “Shame”, and 4) Anticipated Stigma by Association”. Furthermore, the questionnaire contains two additional screening scales: “Healthcare” and “Social support”. Psychometric properties of the COPMI-SQ-r were found to be acceptable to good. Thus, the COPMI-SQ-r is an economic and reliable questionnaire that can be used in research and practice.
In summary, this dissertation contributes to improving prevention for children and adolescents growing up with a parent with a mental illness. Treating the parental mental illness and enhancing parenting skills are important starting points for preventive interventions at the parental level. Furthermore, sustainable support structures for affected families, measures to reduce stigma towards mental health, and participatory research are highlighted as facilitators for improving early identification and preventive support of children and adolescents affected by a parental mental illness. Finally, the findings are interpreted and discussed in light of the current evidence, and implications for research and clinical practice are derived.
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Contributors
Supervisor:
Dates
Issued: 2025-12-05
Relations
Has part: Christiansen, H., Röhrle, B., Fahrer, J., Stracke, M., & Dobener, L.-M. (2020). Kinder von Eltern mit psychischen Erkrankungen: State of the Art für Psychotherapeutinnen, Pädiaterinnen, Pädagoginnen. Wiesbaden: Springer.Has part: Stracke, M., Heinzl, M., Müller, A. D., Gilbert, K., Thorup, A. A. E., Paul, J. L., & Christiansen, H. (2023). Mental Health Is a Family Affair—Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(5), 4485. https://doi.org/10.3390/ijerph20054485Has part: Stracke, M., Gilbert, K., Kieser, M., Klose, C., Krisam, J., Ebert, D. D., Buntrock, C., & Christiansen, H. (2019). COMPARE Family (Children of Mentally Ill Parents at Risk Evaluation): A Study Protocol for a Preventive Intervention for Children of Mentally Ill Parents (Triple P, Evidence-Based Program That Enhances Parentings Skills, in Addition to Gold-Standard CBT With the Mentally Ill Parent) in a Multicenter RCT-Part II. Frontiers in Psychiatry, 10, 54. https://doi.org/10.3389/fpsyt.2019.00054Has part: Toffol, E., Stracke, M., Harlos, N., Lambrecht, S., Brandt, F., Friedrich, S., Kennard, S., Wenzel, L., De Girolamo, G., Gilbert, K., Reck, C., Otto, K., Steinmayr, R., Renneberg, B., Paul, J. L., Thorup, A. A. E., Schwenck, C., Zietlow, A.-L., Wirthwein, L., & Christiansen, H. (2024). Lessons on targeting family mental health and improving outcomes for children of parents with a mental illness. Nature Mental Health, 2(8), 893–900. https://doi.org/10.1038/s44220-024-00285-3Has part: Dobener, L.-M., Stracke, M., Viehl, K., & Christiansen, H. (2022). Children of Parents With a Mental Illness—Stigma Questionnaire: Development and Piloting. Frontiers in Psychiatry, 13, 800037. https://doi.org/10.3389/fpsyt.2022.800037Has part: Stracke, M., Dobener, L.-M., & Christiansen, H. (2024). Children of parents with a mental illness – stigma questionnaire: Validation and revision. Frontiers in Psychiatry, 15, 1376627. https://doi.org/10.3389/fpsyt.2024.1376627
Faculty
FB04:Psychologie
Language
en
Data types
DoctoralThesis
Keywords
Kinder psychisch erkrankter ElternPräventiontransgenerationale Transmission psychischer Störungen
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Stracke, Markus: Children of parents with a mental illness – Starting points and barriers in the implementation of preventive measures. : 2025-12-05.
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