Journal of the American Academy of Child & Adolescent Psychiatry
Clinical reviewChild Affected by Parental Relationship Distress
Section snippets
Proposed Definition for CAPRD
When clinicians are initially exposed to the terminology of CAPRD, it may seem like a fuzzy concept. As the one-sentence definition in the DSM-5 is not detailed enough to clarify the concept, we propose the following expanded definition for CAPRD: This category should be used when the focus of clinical attention is the negative effects of parental relationship distress on a child in the family, including effects on the child’s mental or medical disorders. For this category, “parental
Measuring Parental Relationship Distress
Family researchers have successfully operationalized the assessment of marital or intimate partner relational problems (for example, with the Marital Satisfaction Inventory–Revised [MSI-R]).10 There is a short form of the MSI-R that can be used as a screening tool, which consists of only 10 questions.11 The interviewer asks questions such as: “Does your partner often fail to understand your point of view on things?” “Do minor disagreements with your partner often end up in big arguments?” “Is
Scope of CAPRD
Children, of course, are influenced for better or worse by events that occur in their family, which include the opinions, moods, and actions of the parents and also the interactions between the parents and among all of the family members. Depending on the circumstances of his or her family, a child may be adversely affected to a significant degree when there is persistent or substantial conflict between the parents. Several large studies of psychosocial risk factors for the development of
Differentiating Maladaptive Family Patterns
Although the 4 maladaptive patterns of family interaction that illustrate the CAPRD diagnosis may overlap in features and may co-occur in some families, it is important to understand how they differ from each other.
Discussion
CAPRD is a concept that clinicians and research personnel will find useful once they become familiar with its meaning, scope, and implications. For research in this area to proceed, use of the more stringent definitions for intimate partner maltreatment and intimate partner relationship distress, found in the DSM-5, may be helpful in ascertaining whether either of those problems are occurring in the parents of children presenting with health complaints. The World Health Organization is
References (49)
- et al.
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study
Am J Prev Med
(1998) - et al.
Repeatedly thinking about a non-event: source misattributions among preschoolers
Conscious Cogn
(1994) Psychological maltreatment in the context of separation and divorce
Child Abuse Negl
(1993)Diagnostic and Statistical Manual of Mental Disorders, 5th ed
(2013)- et al.
How Genes Influence Behavior
(2010) - et al.
Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene
Science
(2003) Genes, environments and depressions in young people
Arch Dis Child
(2015)- et al.
Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes
Am J Psychiatry
(2013) - et al.
Description of relational processes: recent changes in DSM-5 and proposals for ICD-11
Fam Process
(2015)
Relationship distress: Impact on mental illness, physical health, children, and family economics
Manual for the Marital Satisfaction Inventory–Revised
Screening for marital and relationship discord
J Fam Psychol
Evidence-based approaches to assessing couple distress
Psychological Assessment
High-Conflict Separation and Divorce: Options for Consideration
Parental alignments and alienation among children of high-conflict divorce
Overview of parental alienation
Configurations of common childhood psychosocial risk factors
J Child Psychol Psychiatry
Intimate partner relationship distress in the DSM-5
Fam Process
Responses to nervous breakdowns in America over a 40-year period: mental health policy implications
Am Psychol
The taxometrics of marriage: is marital discord categorical?
J Fam Psychol
Is marital discord taxonic and can taxonic status be assessed reliably? Results from a national representative sample of married couples
J Consult Clin Psychol
Psychiatric disorders and dissatisfaction with social relationships: does type of relationship matter?
J Abnorm Psychol
Cited by (0)
This article is discussed in an editorial by Drs. Robert R. Althoff and Andrés Martin on page 542.
An interview with the author is available by podcast at www.jaacap.org or by scanning the QR code to the right.
Clinical guidance is available at the end of this article.
Disclosure: Dr. Bernet has received royalties from Charles C Thomas Publisher and Krieger Publishing Co. He has received an honorarium for presenting at the 12th Annual Seminar in Forensic Sciences, South Padre Island, Texas. He has been paid for testifying as an expert witness in child forensic psychiatry. Dr. Wamboldt has received royalties from APA Press and Springer Press. She has received funding from a research grant from Pfizer, Inc. Dr. Narrow reports no biomedical financial interests or potential conflicts of interest.