Family dynamics of families with mental health problems in Finland

This study forms part of the International Family Dynamics Project. Its purpose was describe the family functioning of families with mental health problems on the basis of Barnhill's framework for healthy family systems. The sample consisted of 160 families in which one family member had mental health problems. Both the patients and their relatives took part. The data were collected by questionnaires, i.e. The Family Dynamics Measure and The Family Dynamics Questionnaire. According to the results, mental health patients described family functioning as fairly poor, while relatives described it as fairly good. However, patients' and relatives' perceptions of family functioning did not differ significantly. There were some statistically significant differences between patients' and relatives' perceptions of different family dynamics dimensions. Relatives reported more mutuality (P = 0.006) and clearer communication (P = 0.009) than patients. Older mental health patients reported more isolation than patients under 30. Relatives who mentioned some serious illness in the family reported more role conflict than those who didn't. No differences were found by gender, family structure or education. The results indicated that the mental health problems of a single family member did not impair family dynamics. The study showed that the resources and functioning of families are fairly good in spite of the illness in the family.     

Do places matter? Socioeconomic disadvantage and behavioral problems of children in Canada.

This study evaluated the influence of neighborhoods and socioeconomic disadvantage on behavioral problems rated by parents and teachers in a nationally representative sample of children ages 4 to 11 yrs living in Canada. Between-neighborhood variation accounted for 7.6% and 6.6% of parent and teacher ratings, respectively. About 25.0% of this neighborhood variation could be explained by socioeconomic variables evenly divided between neighborhood and family-level measures. Family socioeconomic status, lone-parent family status, and percentage of lone parents in neighborhoods were strong, reliable predictors of behavioral problems. Ratings were contextualized: Fewer behavioral problems were assessed in children from well-off families living in disadvantaged neighborhoods, whereas more problems were assessed in children from poor families living in advantaged neighborhoods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Triangles in the family circle: Effects of family structure on marriage, parenting, and child adjustment.

Mothers, fathers, and 6- to 10-year-old children used the Family Cohesion Index to type their family system as cohesive (all close), separate (all distant), triangulated (cross-generational coalitions), or detouring (child excluded from the parental sub-system). Family members agreed modestly with one another. Multivariate analyses of variance showed that parents in triangulated families were higher in marital conflict and dissatisfaction than were cohesive and detouring parents. Children in triangulated families reported more interparental conflict and more negative affect in the family. Children in detouring families rated themselves higher in self-blame for their parents' conflicts, and their parents rated them highest in internalizing problems. Parents in separate families rated their children highest in externalizing problems. Implications for the integration of family systems perspectives with research on marriage and parenting are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting during the second year: effects of children's age, sex, and attachment classification

70 2-parent families with 12-month-old infants and 67 2-parent families with 18-month-old toddlers participated in the study. Mothers and fathers participated in separate interviews and filled out questionnaires on family and child behaviors. Mothers and their children participated in the Ainsworth Strange Situation, and the families were observed for a total of 4 hours in their homes. Families were compared on composite measures of family environment variables, parents' perception of their children, and on process variables from home observations. Family differences in environmental stress and marital adjustment showed no effects for attachment classifications, although parents of 12-month-olds reported greater marital adjustment and more pleasure in parenting than parents of 18-months-olds. Both mothers and fathers reported that children classified as resistant were more difficult on several temperament measures. During home observations, 12-month-old children received more positive responses from mothers, and 18-month-old children received more instructions and directions from both parents. Insecure boys (both avoidant and resistant) received the least instructions and directions from both parents, but insecure-avoidant girls received the most instruction from fathers.     

Family functioning among adolescents with bipolar disorder.

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)     

Discourse about adoption in adoptive families.

40 families with adopted children aged 13–19 yrs engaged in semistructured discussions. Family members tended to confirm and avoid disagreeing with one another's assertions about adoption issues. Three types of correlational analysis showed that (a) feelings expressed in open family discussion corresponded with privately expressed feelings, more so in adoptees than in their parents; (b) mothers and fathers tended to acknowledge disadvantages of adoption more than did adoptees, and concordance between parents was high; and (c) acknowledgement vs rejection of differences was not a unidimensional continuum among parents, whereas among children it was a strong unitary dimension of variance. Children whose families reported more problems had low self-esteem scores and expressed greater interest in their biological roots. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescents' perceptions of family functioning in the United Arab Emirates

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.     

Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.

This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post–cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Families, economies, cultures, and science achievement in 41 countries: Country-, school-, and student-level analyses.

This study examines the links between students' families and science achievement across many countries. Science tests and questionnaire responses of 107,834 fifteen-year-olds in 41 countries were analyzed with multilevel analyses. Students had higher science scores if they were native born, lived with two parents, lived without grandparents, lived with fewer siblings (especially older ones), had more educational resources, had more family involvement, lived in wealthier countries, or lived in countries with more equal distributions of household income. In wealthier countries, family involvement, blended families, and number of siblings showed stronger links to science scores. Science achievement was more strongly linked to family socioeconomic status (SES) and educational resources in more egalitarian cultures and to single parents, family SES, resident grandparents, and birth order in more individualistic cultures. Hence, family constructs were linked to academic achievement in all 41 countries, and the links were stronger in more economically and culturally developed countries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of family constellation and schooling to intellectual performance of Mexican American children.

The relationship of 13 family constellation and sociocultural variables to intellectual performance was examined for a sample of 190 Mexican-American preschool children from low-income families. Variables were reduced through a factor analysis that produced 4 independent variables. Intellectual performance was then predicted using an MAXR stepwise multiple regression procedure that generates a new model for each variable entered. The best single-factor predictor on intellectual performance, as measured by the McCarthy Scales of Children's Abilities, was a language/schooling factor that consisted of language of child and parents, parents' schooling attainment, and country (Mexico or the US) in which parents were educated. The best 2-factor model added socioeconomic status to the prediction. Family constellation, consisting of family size and birth order, constituted a clearly separate and distinct factor that contributed less than 3% of the variance in intellectual performance. The relationship of cultural variations to predictions based on the confluence model of R. Zajonc and G. B. Markus (1976) is discussed. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations between family cohesion and adolescent siblings' externalizing behavior.

This study asked whether family cohesion, a measure of whole family functioning, was associated with adolescent siblings' externalizing problems, controlling for the quality of each sibling's relationship with his or her parents. The sample included 93 families (mothers, fathers, and 2 adolescent siblings). Family cohesion was measured from videotaped observations of parents and 2 of their adolescent children discussing family conflict and limit setting. Adolescents reported on hostility in their relationships with mothers and fathers, and parents rated adolescents' externalizing problems. Results from multilevel modeling showed that family cohesion was negatively associated with adolescents' externalizing problems, independent of variance explained by hostility in dyadic parent-child relationships. Results support family systems theory, suggesting that whole family functioning has implications for adolescents' behavioral problems beyond those accounted for by dyadic family relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family and child influences on educational attainment: A secondary analysis of the high/scope Perry Preschool data.

The central question addressed in this study was, What factors contribute to individual differences in the educational attainment of African American young adults from families of low socioeconomic status? A secondary analysis of the Perry Preschool data set was conducted. Unlike earlier studies that focused on the effects of preschool on the Perry participants, this study focused on the influence of family and child characteristics on educational attainment. Results showed that characteristics of the participants at the time of school entry were predictive of the participants' achievement and, ultimately, their educational attainment. Family processes were also related to the participants' achievement, attainment, and study habits. Educational attainment was related to income, occupational prestige, and employment history at age 27. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consequences of irregular versus continuous medical follow-up in children and adolescents with insulin-dependent diabetes mellitus

OBJECTIVES: To study the social and family characteristics of patients with insulin-dependent diabetes mellitus with irregular versus continuous clinical follow-up and to study the medical outcomes of patients with these follow-up patterns. METHODS: An onset cohort of 61 children and adolescents with insulin-dependent diabetes mellitus and their parents were studied. Aspects of their social and family environment were assessed at study inception and examined in relation to frequency of follow-up early in the course of the illness. Follow-up was dichotomized so that patients with continuous follow-up were compared with patients with irregular follow-up, who were defined as those missing 1 full year of planned medical appointments during the second through fourth years after diagnosis. Patients with irregular and continuous follow-up were compared in terms of acute metabolic complications, glycemic control, and retinopathy status during a 10-year period. RESULTS: Compared with individuals with continuous follow-up, patients with irregular clinical visits were more likely to be from families of lower socioeconomic class levels, have a parental history of separation and divorce, and were members of families that reported being least openly expressive of positive emotions. Poor glycemic control in year 1 was associated with irregular follow-up in years 2 through 4. Patients with irregular follow-up continued to have worse glycemic control in years 2 through 4 than patients with continuous follow-up. However, in years 7 and 10 their glycemic control no longer differed from patients with continuous follow-up. More episodes of diabetic ketoacidosis occurred in the irregular follow-up group. Finally, retinopathy occurred more frequently among those in the irregular follow-up group. CONCLUSION: Early irregular clinical follow-up should be considered a risk factor for complications of insulin-dependent diabetes mellitus.     

Piloting the Family Check-Up With Incarcerated Adolescents and Their Parents.

The purpose of the current investigation was to pilot the Family Check-Up (FCU; see T. J. Dishion & K. Kavanagh, 2003) with 10 incarcerated adolescents and their parents or guardians. The FCU is based on principles of motivational interviewing (W. R. Miller & S. Rollnick, 2002). The authors delivered FCU with a high degree of fidelity and adherence on the basis of ratings from parents, therapists, and observers. Results suggest that the FCU positively impacted families (effect sizes were generally in the medium range). After our intervention, adolescents were more confident in their ability to resist drug use, and parents were more confident in their ability to impact their adolescents' risky behaviors. Parents and adolescents both reported being highly satisfied with this intervention. These results warrant further investigation of the FCU with incarcerated adolescents and their families in a controlled clinical trial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CO2 and indomethacin vasoreactivity in patients with cranial trauma]

The impact of a cancer diagnosis upon a family has become a focus of clinical interest, but few scientific studies have been completed in this area. The objectives of this pilot study were twofold: first, to test the applicability of the Family System Test (FAST) in families (n = 5) with a young adult member with cancer and secondly to evaluate patterns of interactions within these families. Results show that the FAST is applicable and useful to evaluate the different perceptions of hierarchy and cohesion--two essential variables--within these families. The great majority of family members represented their relationships as balanced (i.e., cohesive and moderately hierarchical). However, contrary to nonclinical families, fathers had a less positive view than mothers and patients: fathers more often perceived family and parenteral relations as unbalanced, and also more often perceived a reversal of hierarchy and a cross-generational coalition within the family. Implications for future research and clinical care are discussed.     

Family interaction, parenting style, and the development of planning: A longitudinal analysis using archival data.

Data from 68 families that participated at 3 times in the Family Socialization and Developmental Competence Project (D. Baumrind, 1973) were used to study children's participation in planning-related discussions during family interactions in relation to parenting style. Results indicate that such discussions occur from early in the child's life and that with age children initiate more of them. Children's initiations at adolescence were predicted by the frequency of initiations when the child was 9 years old and by parenting style. Children with authoritative, permissive, and uninvolved parents initiated more planning discussions in adolescence than children with directive parents. The benefits and limitations of analyzing archival family data in such research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parental marital status, income, and family functioning on African American adolescent self-esteem.

This study examined the effects of marital status, family income, and family functioning on African American adolescents' self-esteem. One hundred sixteen adolescents participated, 64% of whom were female. Compared with boys with nonmarried parents, boys with married parents had higher overall self-esteem, even when family income and family functioning were controlled. Parental marital status had no effect on girls' self-esteem. Family functioning was a very strong predictor of self-esteem for both sexes. However, family relational factors were more important to girls' self-esteem, whereas structural and growth factors were more important for boys. It was concluded that African American adolescent boys with nonmarried parents are at risk for developing low self-esteem compared with other African American adolescents, but a more controlled and structured environment may buffer the effects of having nonmarried parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coparenting around siblings' differential treatment in Mexican-origin families.

In this study we examined patterns of mothers' and fathers' differential affection and discipline toward 2 adolescent offspring in 243 Mexican-origin families. Grounding our work in a family systems perspective, we used interparental patterns of differential treatment as an index of the coparental alliance and tested their associations with parents' reports of familism values, traditional gender role attitudes, and cultural orientations. We also sought to replicate prior research on European American samples linking interparental patterns of differential treatment to marital qualities (coparenting satisfaction, love, and conflict) and adolescent depressive symptoms and risky behaviors. Three interparental patterns emerged: families in which both mothers and fathers treated their 2 offspring equally, incongruent families in which 1 parent treated both offspring equally while the other parent favored 1 offspring, and congruent families in which both parents favored the same offspring. Most parents reported equal treatment, but others fell into the incongruent affection (30%), incongruent discipline (45%), and congruent discipline (16%) groups. Mixed model analyses of variances revealed that in families in which mothers and fathers both treated their offspring equally, parents reported higher familism values, more traditional gender role attitudes, and relatively stronger orientations to Mexican than Anglo culture. Consistent with previous research, interparental incongruence was associated with less positive marital qualities and more adolescent adjustment problems. Discussion focuses on the role of culture in shaping coparenting and the processes through which these coparenting dynamics are linked to marital and youth adjustment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)