Birth Order and Psychopathology PDF
Birth Order and Psychopathology PDF
Birth Order and Psychopathology PDF
Journal of
Family Medicine
Journal of Family Medicine and Primary Care • Volume 1 • Issue 2 • July-December 2012 • Pages 81-***
A BSTRACT
Context: Ordinal position the child holds within the sibling ranking of a family is related to intellectual functioning, personality,
behavior, and development of psychopathology. Aim: To study the association between birth order and development of
psychopathology in patients attending psychiatry services in a teaching hospital. Settings and Design: Hospital-based cross-sectional
study. Materials and Methods: Retrospective file review of three groups of patients was carried out. Patient-related variables like age
of onset, birth order, family type, and family history of mental illness were compared with psychiatry diagnosis (ICD-10) generated.
Statistical Analysis: SPSS 13; descriptive statistics and one-way analysis of variance (ANOVA) were used. Results: Mean age of
onset of mental illness among the adult general psychiatry patients (group I, n = 527) was found to be 33.01 ± 15.073, while it was
11.68 ± 4.764 among the child cases (group II, n = 47) and 26.74 ± 7.529 among substance abuse cases (group III, n = 110). Among
group I patients, commonest diagnosis was depression followed by anxiety and somatoform disorders irrespective of birth order.
Dissociative disorders were most prevalent in the first born child (36.7%) among group II patients. Among group III patients, alcohol
dependence was maximum diagnosis in all birth orders. Conclusions: Depression and alcohol dependence was the commonest
diagnosis in adult group irrespective of birth order.
Introduction age 15, significantly more girls, first borns, and children from
small families had DSM-III disorders, but the interactions
The possibility that the ordinal position a child holds within the between them were not significant.[20] However, few studies
sibling ranking of a family may predict intellectual functioning, have specifically examined the effect of birth order on young
personality, and behavior has been the subject of extensive adult mental health, and the results of most of the birth
research.[1-3] Alfred Adler proposed the effects of birth order order studies are contradictory and unsystematized.[14] In a
on human personality characteristics, which led to an increased comprehensive review of early studies investigating the effects
motivation of scientists toward birth order studies.[4] Different of birth order, it was considered that the principal difficulties
modalities of personality and human behaviors became the inherent in the majority of studies were the lack of adequate
focus of research which included intelligence, achievements, theoretical bases and derived explicit hypotheses.[8,9] Theoretical
mental ability, sexual orientation, etc. This debate on birth explanations may arise from biological factors unidentified here
order characteristics later involved psychiatric illnesses such and/or psychological stressors linked with these positions. The
as obsessive–compulsive disorder,[5] schizophrenia,[6-11] gender influence of siblings on the socialization of the individual has
identity disorder, and somatization disorder.[12] Studies have been recognized as a fact by both psychology and sociology.[1]
investigated the associations between birth order and various However, the significance of sibling order for the outbreak of
forms of psychopathology, including depression,[13] alcohol psychiatric diseases is still discussed controversially. A recent
abuse,[14] autism spectrum disorder,[15,16] anorexia nervosa,[17] study pointed toward the possibility that later birth order results
delinquency,[18] and the negative effects on well-being.[19] But in a more severe form of schizophrenia.[21]
such association remains unclear due to lack of consideration
of the confounding effects of family size.[3] In adolescence, at Considering all the above-mentioned facts and figures, this study
has been taken up with an aim to study the possible association
Access this article online of birth order and development of psychopathology among
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the patients attending the psychiatry services in a tertiary care
Website:
www.jfmpc.com hospital.
Address for correspondence: Dr. Ajay Risal,
DOI: Department of Psychiatry, Dhulikhel Hospital,
10.4103/2249-4863.104985 Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.
E-mail: [email protected]
Journal of Family Medicine and Primary Care 137 July 2012 : Volume 1 : Issue 2
Risal and Tharoor: Birth order and psychopathology
Journal of Family Medicine and Primary Care 138 July 2012 : Volume 1 : Issue 2
Risal and Tharoor: Birth order and psychopathology
Table 4: Effect of birth order on psychopathology our practice settings. Considering the above-mentioned limiting
Groups Mean square df F Significance
factors, our future directions include analyzing the differential
effects of single child versus multiple children in nuclear families.
I 20.151 1 1.564 0.212
II 8.167 1 0.452 0.505
Additionally, researchers may like to examine the correlation of
III 17.547 1 1.509 0.222 birth order and diagnosis across generations in the families to be
studied. A prospective study and use reconstruction method to
make corrections for the effect of family size as explained above
analyzing familial data on psychiatric patients, which may be one may also be useful. In conclusion, our study has been explorative
of the limiting factors in our study aimed to assess the effect in nature and only looked at the distribution of diagnoses across
of birth order on psychopathology. Similarly, the retrospective birth orders and did not find a definite association of birth order
method of data collection in our study may not be a suitable and psychopathology.
process to avoid sampling and respondent related biases. Our
endeavor of assessing birth order effects on development of
psychopathology despite so many methodological shortcomings References
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How to cite this article: Risal A, Tharoor H. Birth order and
12. Birtchnell J. Mental illness in sibships of two and three. Br
psychopathology. J Fam Med Primary Care 2012;1:137-40.
J Psychiatry 1971;119:481-7.
13. Putter P. The effects of Birth order on depressive Source of Support: Nil. Conflict of Interest: None declared.
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Journal of Family Medicine and Primary Care 140 July 2012 : Volume 1 : Issue 2