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.

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.