Abstract
Introduction: Adults who grow up with a parent with severe mental illness are exposed to prolonged developmental adversity, yet little is known about how this experience shapes multidimensional outcomes in adulthood. In particular, the roles of personal adaptive resources, childhood trauma, parental bonding, and morbidity in influencing quality of life, social functioning, and healthcare utilization remain insufficiently understood. This study aimed to examine the relationships between personal adaptive resources (resilience and general self-efficacy), childhood experiences (trauma and parental bonding), and adult outcomes, including quality of life, social functioning, morbidity, and healthcare utilization, as well as to examine the moderating role of resilience.
Design: A cross-sectional quantitative design was employed.
Methods: A convenience sample of 300 adults who grew up with a parent with severe mental illness completed a self-report questionnaire which consisted of validated scales for study variables: Personal Wellbeing Index-Adult, Connor-Davidson Resilience Scale-10, New General Self-Efficacy Scale, Social Functioning Questionnaire, Parental Bonding Instrument, Childhood Trauma Questionnaire, and EUROHIS survey items for morbidity and healthcare utilization. Data were analyzed using Spearman correlations, hierarchical multiple linear regression, negative binomial regression, and moderation analysis using PROCESS.
Results: Resilience and self-efficacy independently predicted higher quality of life. Childhood trauma and parental overprotection independently predicted poorer social functioning, while parental care did not contribute unique variance in multivariate models. Childhood trauma significantly predicted morbidity, and morbidity was associated with increased healthcare utilization. Resilience did not moderate the relationship between childhood trauma and either morbidity or social functioning, indicating independent rather than interactive effects.
Conclusion: Among adults who grew up with a parent with SMI, resilience and self-efficacy function as independent contributors to subjective wellbeing, while childhood adversity and morbidity shape long-term social and health outcomes. Resilience does not appear to buffer the long-term effects of trauma on health or functioning.
Notes
Funding Acknowledgement: Dr. Alexander Shestiperov is a 2025 Sigma Small Grant Recipient.
Open Access Details:
This is an open access article originally published under the terms of a Creative Commons License, which permits the Sigma Repository to post a copy in its collections. The license is attached to this item record; please click on the license for further details.
Original Article Citation:
Shestiperov, A., Kagan, I. and Grinstein-Cohen, O. (2026), Growing in the Shadow of Mental Illness: Quality of Life, Health Status, Social Functioning, and Health Care Utilization Among Adults to Parents With Severe Mental Illness. J Nurs Sch, 58: e70118. https://doi.org/10.1111/jnu.70118
No changes have been made to this article.
Sigma Membership
Upsilon Xi at-Large
Lead Author Affiliation
Ben-Gurion University of the Negev, Be'er Sheva, Israel
Type
Article
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Childhood Trauma, Mental Health, Parental Bonding, Resilience, Self-Efficacy, SMI, Medical Care Use, Psychological Resilience, Health Status Indicators, Mental Illness, Parent-Child Relationships, Severity of Illness Index, Emotional Trauma, Quality of Life, Social Skills, Psychology of Parents, Israel
Recommended Citation
Shestiperov, Alexander; Kagan, Ilya; and Grinstein-Cohen, Orli, "Growing in the Shadow of Mental Illness: Quality of Life, Health Status, Social Functioning, and Health Care Utilization Among Adults to Parents with Severe Mental Illness" (2026). Individual Articles. 55.
https://www.sigmarepository.org/individual_articles/55
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publisher
Sigma Theta Tau International
Version
Publisher's Version
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
External Review: Previously Published Material
Acquisition
Indexed Previously Published Material (Per Creative Commons License)
Date of Issue
2026-10-12
Full Text of Presentation
wf_yes
Funder
Sigma Foundation for Nursing
