How Family Dynamics Effect Research Posted on May 2, 2006 Differing views of the child can make research decisions difficult, says David A. Axelson (bio).

One thing that's a challenge in dealing with children and teenagers and bipolar disorder and their families in research is you've got a number of different perspectives, from one parent versus the other can be very different. Kids can react very differently with their fathers than their mothers. They can react very differently with a parent or caregiver who's with them infrequently versus very frequently, and that is something that kids, tend to show symptoms more likely in environments that they feel safe or that they're used to. So that's often times, in our culture, with moms, and so that a dad can, when you interview them, may say, Well, I have very little problems with this child, but he's only with the child for a certain period, a relatively small period of time, or the child is a little intimidated by the father, and so they are able to hold things together much more readily than when they're more relaxed with their mom or with siblings.

That also actually comes into play a bit with diagnostic issues with school, too, because some kids, especially if they're not floridly symptomatic, are going to be able to hold it together somewhat in school environment with that extra peer pressure, teacher pressure and fear of embarrassment and not wanting to sort of let people know what's going on inside. Whereas, when they get home, sometimes then they let it all out, regardless of whether it's mom, dad, siblings, whatever. And so, it can be hard when you see somebody where you're getting school reports or the parent and child are reporting they're doing okay in school, yet you're hearing about all of these terrible symptoms and aggression, poor performance outside of that school environment. And you sort of scratch your head and say, Can this kid really have this illness if they're managing okay in school? And that is definitely a challenge.

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