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1.
Twenty three adolescents with a history of cancer, 27 physically abused adolescents, and 23 healthy, nonabused adolescents were administered structured posttraumatic stress disorder (PTSD) interviews and self-report questionnaires regarding family functioning. Thirty five percent of adolescent cancer subjects met criteria for lifetime PTSD as compared to only 7% of the abused adolescents: 17% of the cancer subjects and 11% of the abuse subjects met criteria for current PTSD. Adolescents with cancer viewed their mothers and fathers as significantly more caring and more protective than the comparison and abused adolescents. Cancer subjects who met criteria for lifetime PTSD saw their families as significantly more chaotic than those who did not have PTSD. Eighty three percent of cancer subjects who had lifetime PTSD also had mothers who had PTSD.  相似文献   

2.
Posttraumatic stress (PTS) symptoms have been reported in mothers and fathers of childhood cancer survivors; however, little is known about patterns of PTS in these families. Cluster analysis was applied to the Posttraumatic Stress Disorder (PTSD) Reaction Index scores of 98 couples parenting adolescent childhood cancer survivors to describe patterns of PTS in families, yielding the following 5 clusters: Minimal PTS, Mothers Elevated, Disengaged, Fathers Elevated, and Elevated PTS. The clusters were validated using data from a structured psychiatric interview, an additional self-report measure of PTS, and an index of family functioning. These clinically meaningful patterns reveal that a majority of families had at least one parent with moderate to severe PTS, which supports development of family-based interventions for this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

3.
Despite the importance of family context to adolescents' reactions following disaster, little research has examined the role of parents' functioning on adolescents' disaster-related posttraumatic stress disorder (PTSD) symptoms. Using data from 288 adolescents (ages 12 to 19 years) and 288 parents exposed to a series of severe tornadoes in a rural Midwestern community, this study tested a conceptual model of the interrelationships between individual and parental risk factors on adolescents' disaster-related PTSD symptoms using structural equation modeling. Results showed that the psychological process of experiential avoidance mediated the relationship between family disaster exposure and PTSD for both adolescents and their parents. Parents' PTSD symptoms independently predicted adolescents' PTSD symptoms. Further, parents' postdisaster functioning amplified the effects of adolescent experiential avoidance on adolescents' disaster-related PTSD symptoms. Findings highlight the importance of family context in understanding adolescents' postdisaster reactions. Clinical implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)  相似文献   

4.
5.
Adolescents with alcohol dependence or abuse (n?=?126) were compared with 124 adolescents with other (nondrug) mental disorders and with a control group of 94 adolescents with no mental disorders on dimensions of family functioning. General family functioning, mother–adolescent relationships, and parental monitoring and discipline practices were assessed by using both adolescent and mother reports. Although overall the groups differed significantly on all family variables, the relationships among groups differed for adolescent and mother reports. By mother reports, families of adolescents with alcohol use disorders functioned less well than did families of adolescents with other mental disorders, whereas by adolescent reports these groups were not significantly different. Examination of both adolescent and mother perspectives may be important in understanding the relationship between family functioning and adolescent alcohol use disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

6.
Objective: To investigate the severity of posttraumatic stress (PTS) and the prevalence of posttraumatic stress disorder (PTSD) in individuals with pediatric spinal cord injury (SCI) and their parents and to assess relationships among family members' degree of PTS and PTSD diagnoses. Study Design: Cross-sectional mail survey. Setting: A pediatric orthopedic surgical and rehabilitation hospital. Participants: A volunteer sample of 64 pediatric SCI patients (59% male and 41% female), 64 mothers, and 49 fathers. Main Outcome Measures: The Posttraumatic Diagnostic Scale was used for parents and for patients more than 18 years of age and the Child Posttraumatic Stress Scale was used for patients 18 years of age and under. Results: Sixteen (25.4%) patients, 25 (41%) mothers, and 16 (35.6%) fathers reported current PTSD. Mothers' total PTS scores statistically predicted patients' and fathers' PTS scores, and patients' PTS scores statistically predicted mothers' PTS scores. In addition, mothers' and patients' PTSD diagnoses related significantly. Conclusions: PTSD may be among the most prevalent psychological comorbidities in families experiencing pediatric SCI. Screening and treatment for PTSD appear warranted as part of standard psychosocial care for these families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

7.
This longitudinal study of physical injury survivors examined the degree to which Hispanic and non-Hispanic Caucasians reported similar posttraumatic stress disorder (PTSD) symptoms. Adult physical trauma survivors (N = 677) provided information regarding posttraumatic distress by completing an interview-administered version of the PTSD Symptom Checklist (Civilian version) at 3 time points: within days of trauma exposure and again at 6 and 12 months posttrauma. Structural equation modeling with propensity weights was used in analyzing data. Results replicated prior research indicating that Hispanics report greater overall PTSD symptom severity. However, the size of this effect varied significantly across the 17 individual PTSD symptoms, and several symptoms were not reported more highly by Hispanics. Relative to non-Hispanic Caucasians, Hispanics tended to report higher levels of symptoms that could be regarded as exaggerated or intensified cognitive and sensory perceptions (e.g., hypervigilance, flashbacks). In contrast, few differences were observed for symptoms characteristic of impaired psychological functioning (e.g., difficulty concentrating, sleep disturbance). Findings suggest that the pattern of PTSD symptoms experienced most prominently by Hispanics differs in kind and not merely in degree. Results have implications for theory aimed at explaining this ethnic disparity in posttraumatic psychological distress as well as for clinical intervention with trauma-exposed Hispanics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

8.
This study examined the characteristics of families of adolescents with bipolar disorder during or shortly following a period of mood exacerbation, using measures of family conflict, cohesion, adaptability, and expressed emotion (EE). Demographic, diagnostic, and family functioning data were collected from 58 families (mean age = 14.48; 33 female, 25 male) before entering a randomized trial of family focused treatment. Compared to scale scores reported by healthy adolescents and their families, cohesion and adaptability were more impaired in families with an adolescent with bipolar disorder. Levels of conflict, while higher than normative scores reported by healthy families, were not significantly different from scores gathered from distressed, clinic-referred families. Parents rated high in EE reported less cohesion and adaptability, and more conflict, than parents rated low in EE. Parents expressing greater numbers of critical comments also reported more conflict than those who expressed fewer criticisms. These EE group differences were not accounted for by concurrent adolescent symptom levels. Family adaptability, cohesion, and conflict may be important targets for family treatments administered during the postepisode phases of early onset bipolar disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

9.
A sample of 710 subjects between 14 and 19 years of age were examined to assess psychological health of United Arab Emirates (UAE) families with adolescent members. The Family Functioning Questionnaire (FFQ) based upon the adolescent's perception of his or her family life and climate contains seven dimensions that constitute the family functioning process: family structure, emotional fulfillment, internal relations, behavioral control, value transmission, basic requirements, and external relations. Results indicate that the adolescents perceived their families to be operating more toward the functional than dysfunctional end of the scale. Males scored their families more functional in family structure and in external relations more significantly than did females. Females perceived their families as more functioning in internal relations, behavioral control, and basic requirements. However, a trend was found in favor of males on emotional fulfillment. Family functioning scores were higher in upper social economic status (SES) families than in other SES levels.  相似文献   

10.
The goal of this study was to determine how family functioning influences the onset of adolescent cigarette smoking and how family functioning and parental smoking together influence adolescent smoking. A 6-year prospective design was used to follow a group of 508 families with a child aged 11–13 years. Predictor measures were parents" smoking status at Time 1, parents" scores on scales measuring family cohesion and parent–adolescent strain, and adolescents" scores on 3 scales measuring psychological adjustment. Results showed that poorer family functioning predicted subsequent adolescent smoking, independent of other measured factors. The strongest predictions were yielded by the combination of low family cohesion and parental smoking, with early adolescents who had a parent who smoked and low family cohesion reporting more than twice the rate of smoking in late adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

11.
57 delinquent adolescents received family ecological treatment, 23 delinquent adolescents received an alternative treatment, and 44 normal adolescents served as developmental controls. The mean age of the adolescents at pretreatment was 14.8 yrs. Pre- and posttreatment assessments were conducted with the adolescent and his/her parents. Measures included the Behavior Problem Checklist, the Eysenck Personality Inventory, and self-report and observational measures of family relations. Ss who received family ecological treatment evidenced significant decreases in conduct problems, anxious-withdrawn behaviors, immaturity, and association with delinquent peers. The mother–adolescent and marital relations in these families were significantly warmer, and Ss were significantly more involved in family interaction. In contrast, the families who received the alternative treatment evidenced no positive change and showed deterioration in affective relations. The normal families manifested relationship changes that were consistent with those identified by investigators of normal adolescent development. Findings support a multisystemic model of behavior disorders and treatment. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

12.
The purpose of this study was to quantify and to identify predictors of posttraumatic stress disorder (PTSD) symptomatology after traumatic brain injury (TBI). Fifty children aged 6 to 14 years, hospitalized after TBI, were assessed soon after TBI regarding injury severity and preinjury psychiatric, socioeconomic, family functioning, and family psychiatric history status; neuroimaging was also analyzed. Psychiatric assessments were repeated 3, 6, 12, and 24 months after TBI. Only 2 of 46 (4%) subjects with at least one follow-up assessment developed PTSD. However, the frequency with which subjects experienced at least one PTSD symptom ranged from 68% in the first 3 months to 12% at 2 years in assessed children. The presence of an internalizing disorder at time of injury followed by greater injury severity were the most consistent predictors of PTSD symptomatology. It is apparent, therefore, that PTSD and subsyndromal posttraumatic stress disturbances occur despite neurogenic amnesia. These problems should be treated, particularly if symptoms persist beyond 3 months.  相似文献   

13.
Objective: This study evaluated the relations between posttraumatic stress disorder (PTSD) symptoms and poor family functioning in veterans and their partners. Method: Data were collected from Caucasian veterans with PTSD (N = 1,822) and their partners (N = 702); mean age = 53.9 years, SD = 7.36. Veterans completed the Posttraumatic Checklist Military Version (PCL-M) and, along with their partners, completed the McMaster Family Assessment Device (FAD-12). Assessments were conducted at intake into a treatment program at 3 months and 9 months posttreatment. Results: Structural equation models (SEMs) were developed for veterans as well as for veterans and their partners. Poor family functioning for veterans at intake predicted intrusion (β = .08), hyperarousal (β = .07), and avoidance (β = .09) at 3 months posttreatment. At 3 months posttreatment, family functioning predicted hyperarousal (β = .09) and avoidance (β = .10) at 9 months. For veterans and their partners, family functioning at intake predicted avoidance (β = .07) at 3 months, and poor family functioning at 3 months predicted intrusion (β = .09) and hyperarousal (β = .14) at 9 months. The reverse pathways, with PTSD symptoms predicting poor family functioning, were only evident with avoidance (β = .06). Conclusion: Family functioning may play a role in treatment for veterans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

14.
Despite the large and growing numbers of adoptive families, little research describes interactions in families with adopted adolescents. Yet, adopted adolescents' increased risk for adjustment problems, combined with the association between family interactions and adolescent adjustment in nonadoptive families, raises questions about differences in adoptive and nonadoptive family interactions. We compared observed and self-reported family interactions between 284 adoptive and 208 nonadoptive families and within 123 families with 1 adopted and 1 nonadopted adolescent. Adolescents averaged 14.9 years of age. Comparisons were made using analysis of variance incorporating hierarchical linear methods in SAS PROC MIXED to control family-related correlations in the data. Parents and children reported more conflict in adoptive families when compared with nonadoptive families. Families with 1 adopted and 1 nonadopted adolescent reported more conflict between parents and adopted adolescents. Observed parental behavior was similar across adoptive and nonadoptive children although adopted adolescents were less warm and, in families with 2 adopted children, more conflictual than nonadopted adolescents. These findings suggest a need for further investigation of the association between family interactions and adopted adolescent problem behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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16.
Adolescent cancer is uncommon and presents an exceptional stress for the young patient and their parents. The emotional needs of adolescents with cancer are a major factor in the recommendation for the establishment of adolescent cancer units in major cancer centres in the U.K. However, there have been no prospective, longitudinal studies assessing the psychological impact of a diagnosis of cancer on the adolescent patient and their family. In 1994 we began a longitudinal study of the emotional impact of the diagnosis of cancer in patients and their families presenting to an adolescent cancer unit and of the coping strategies they employ. This first report presents the results of the study at the time of diagnosis in 42 adolescents, 34 mothers and 27 fathers. The Beck Depression Inventory (BDI) was used to assess depression and anxiety levels were measured using Spielberger's State Trait Anxiety Inventory (STAI). Adolescents and their parents completed the questionnaires on first admission to the adolescent cancer unit. The median time since cancer diagnosis was approximately 3 weeks. To provide normative data for the U.K. adolescent population, control values were obtained from 173 pupils of the same age and background. The results showed that, contrary to expectation, adolescents with cancer were no more anxious or depressed than the control adolescent population. Nevertheless, a substantial minority of patients and controls had elevated anxiety or depression scores. Girls were significantly more anxious (P = 0.011) and depressed (P < 0.0001) than boys. Mothers were the most anxious family members and were significantly more anxious than fathers (P = 0.038). Parental anxiety scores, especially mothers, were much higher than reported norms. There was no significant difference between mothers' and fathers' depression scores. Although at the time of diagnosis adolescent cancer patients are not more anxious or depressed than their healthy peers, many adolescents without cancer are anxious or depressed. Staff on adolescent cancer units should therefore be aware of the frequency of emotional disturbance in this population. Mothers are the most anxious family members. Although the findings are relatively reassuring at the time of diagnosis, follow-up data from this cohort will show whether anxiety and depression change with treatment involving intensive chemotherapy, surgery and radiotherapy and will indicate the coping strategies which patients and their families adopt in dealing with both the disease and its treatment.  相似文献   

17.
Parents' marital functioning and adolescent psychopathology were investigated in 2 studies. The first study compared parents' marital satisfaction, conflict over childrearing, affective communication, and traditional role orientation in matched samples of psychiatric inpatient and control-group adolescents. The second study examined associations between specific dimensions of marital functioning and adolescent depression severity, suicidal ideation, and social adjustment in a larger sample of adolescent inpatients. In Study 1, parents of inpatients reported less marital satisfaction and more conflicts over childrearing than parents of control-group adolescents. In Study 2, marital conflicts over childrearing were associated with a less active or involved father–adolescent relationship and more severe school behavior and spare time problems. Marital functioning was not associated with depression severity or suicidal ideation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

18.
This study investigated the bidirectional relationships of adolescents’ and maternal mood, and the moderating effect by gender and perceived family relationships on these relationships. Data were obtained from 626 adolescent-mother dyads and follow-up data were collected one year later from a subset. Adolescents reported their depressive symptoms, and their mothers reported their negative affect. Adolescents described their perception of family relationships. Maternal negative affect and adolescents’ depressive symptoms were significantly correlated at baseline. This association was moderated by gender and family relationships. The association was stronger in mother-daughter compared to mother-son dyads. In families where relationships were reported to be poor, adolescent depressive symptoms were uniformly high, regardless of maternal negative affect. However, in families where relationships were good, maternal negative affect was associated with higher adolescents’ depressive symptoms. In longitudinal analyses, adolescents’ mood at baseline was found to relate to maternal negative affect at follow-up. Family relationships at baseline were also associated with adolescents’ depressive symptoms at follow-up. However, there was no prediction from maternal negative affect at baseline to adolescents’ depressive symptoms at follow-up. Gender and quality of family relationships did not moderate the longitudinal relationships between adolescents’ depressive symptoms and maternal negative affect in either direction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

19.
Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder among adolescents. While the effects of PTSD on quality of life (QOL) have been systematically studied with adults, research on the consequences of PTSD with adolescents has been limited. Among the other psychiatric disorders often associated with PTSD, major depression and alcohol use disorders are prevalent and have their own substantial morbidities. This study was designed to examine and compare the effects of PTSD, major depression, and alcohol use disorders on quality of life during adolescence. The subjects were 540 adolescents (ages 12-18 years old) recruited from clinical and community sources. Psychiatric disorders characterizing the sample included one or more of the three disorders studied (n = 275), other psychiatric disorders (n = 121), or no psychiatric disorders (n = 144). Analysis of covariance was utilized to determine the individual main effects and relative effects sizes of the three primary disorders on QOL variables. PTSD showed significant adverse effects on psychological, physical, and social functioning. Major depression showed a similar pattern. In contrast, alcohol use disorders primarily affected role functioning. While PTSD, major depression, and alcohol use disorders all adversely influenced adolescent QOL, the patterns of their effects differed. Remedial treatment interventions designed to restore QOL for adolescents with these disorders may need to focus on different areas for adolescents with PTSD or major depression than for adolescents with alcohol use disorders.  相似文献   

20.
OBJECTIVE: To examine posttraumatic stress disorder (PTSD) in mothers of survivors of childhood cancer. Comorbidity of anxiety and depressive disorders, prevalence of subclinical PTSD, and the utility of a self-report measure as a screening instrument for PTSD were also investigated. METHOD: Mothers (n = 65) completed a questionnaire self-report PTSD checklist (PCL-C). Mothers were administered several modules of the SCID: nonpatient edition by telephone, including the PTSD, Generalized Anxiety, and Major Depressive Disorder modules. RESULTS: We diagnosed 6.2% of the sample with current PTSD. An additional 20% had subclinical PTSD. One of four mothers with PTSD diagnoses had a comorbid diagnosis of an anxiety and depressive disorder. The PCL-C evidenced diagnostic utility as a screening instrument. However, a moderate number of false-positives would result if the recommended cut-off on the instrument was used. CONCLUSIONS: The PCL-C had diagnostic utility in screening mothers of childhood cancer survivors. The presence of comorbid diagnoses such as anxiety and depression should be examined.  相似文献   

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