Family relations,mental health and adherence to nutritional guidelines in patients facing dialysis initiation

This study investigated the effect of family relations on patients’ adjustment to dialysis. The two main aims were to develop a family typology, and to explore the influence of family profile on the patient's anxiety, depression and adherence to nutritional guidelines. The sample consisted of 120 patients (mean age 63 years; 67.5% of men). They completed several measures 1, 6 and 12 months after dialysis initiation. The scales used were the Family Relationship Index and the Hospital Anxiety and Depression Scale. Perceived adherence to nutritional guidelines was assessed using two visual analogical scales. Results showed that family relations remained stable over time. Cluster analysis yielded three family profiles, which were named conflict, communicative and supportive families. Patients belonging to conflict families perceived themselves as less adhering to nutritional guidelines. For these patients, anxiety and depressive moods increased significantly over time, whereas mental health remained stable over time for communicative and supportive families. This research underlines that family relations are essential in global consideration of the care of patients treated by dialysis. Conflict families seem especially at risk. They should be identified early to help them adapt to this stressful treatment.     

Relation of Family Problems to Patterns of Delinquent Involvement Among Urban Youth

The relation of patterns of family problems and patterns of delinquent behavior over time was evaluated among a sample of inner-city minority adolescent males. Empirically derived groups were identified and included: nonoffenders, chronic minor offenders, escalators, and serious chronic offenders. Patterns of family problems were also identified and differentially related to delinquency groups. Members of the group involved in serious chronic offending were more likely to have families characterized by multiple problems including disruption, conflict, and lack of parental involvement, sometimes so extreme as to meet the legal requirement of neglect. They were also more likely to have families characterized by deviant behavior and attitudes. The finding of specific relations between types of family problems and patterns of delinquent behavior has important implications for intervention and prevention. Rather than assuming a general relation between family functioning and delinquent involvement, specific aspects of family functioning may need to be targeted to affect different patterns of delinquent involvement.     

Unfolding Relations among Mindful Parenting,Recurrent Conflict,and Adolescents’ Externalizing and Internalizing Problems

The current study examined unfolding relations among mothers’ mindful parenting, parent–adolescent recurrent conflict, and adolescents’ externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2–3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent–adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.     

Social support and patient adherence to medical treatment: a meta-analysis.

In a review of the literature from 1948 to 2001, 122 studies were found that correlated structural or functional social support with patient adherence to medical regimens. Meta-analyses establish significant average r-effect sizes between adherence and practical, emotional, and unidimensional social support; family cohesiveness and conflict; marital status; and living arrangement of adults. Substantive and methodological variables moderate these effects. Practical support bears the highest correlation with adherence. Adherence is 1.74 times higher in patients from cohesive families and 1.53 times lower in patients from families in conflict. Marital status and living with another person (for adults) increase adherence modestly. A research agenda is recommended to further examine mediators of the relationship between social support and health.     

Family Support and Conflict: Prospective Relations to Adolescent Depression

The relations between family support, family conflict, and adolescent depressive symptomatology were examined longitudinally in a sample of 231 female and 189 male adolescents and their mothers. Structural equation models revealed that less supportive and more con-flictual family environments were associated with greater depressive symptomatology both concurrently and prospectively over a 1-year period. Conversely, adolescent depressive symptomatology did not predict deterioration in family relationships. Depressive symptomatology and, to a greater extent, family characteristics showed high levels of stability over the 1-year period. Counter to our expectations, the relations between family variables and depressive symptomatology were similar for boys and girls. The results suggest that the quality of family interactions is relevant for understanding the development of depressive symptoms in adolescents.     

Comparison of Schizophrenic Patients' Families and Normal Families in China,Using Chinese Versions of FACES-II and the Family Environment Scales

The lack of measures that systematically evaluate the characteristics and functioning of Chinese families is hindering the development of appropriate family interventions for schizophrenia in China. We assessed the reliability and validity of revised and adapted Chinese versions (CV) of the Family Adaptability and Cohesion Evaluation Scales (FACES-II-CV) and the Family Environment Scales (FES-CV) and administered these instruments to 120 respondents from families with a schizophrenic member and 126 respondents from control families. The psychometric properties of the FACES-II-CV and of the FES-CV Cohesion, Conflict, Intellectual-Cultural Orientation, and Active-Recreational Orientation scales are satisfactory, so they are appropriate for use in China; the remaining six FES-CV scales require further culturally appropriate revision. Compared to control families, families with schizophrenic patients in China have higher conflict, lower cohesion, poor adaptability, and are less likely to be involved in intellectual and recreational activities. These differences remained significant after adjusting for family and respondent characteristics.     

Relations between coparenting and father involvement in families with preschool-age children

A sample (N = 112) composed primarily of European American and middle-class two-parent families with a resident father and a 4-year-old child (48% girls) participated in a longitudinal study of associations between coparenting and father involvement. At the initial assessment and 1 year later, fathers reported on their involvement in play and caregiving activities with the focal child, and coparenting behavior was observed during triadic family interactions. Structural equation modeling was used to test cross-lagged associations between coparenting behavior and father involvement. Overall, paths from father involvement to coparenting behavior were significant, but paths from coparenting behavior to father involvement were not. Specifically, greater father involvement in play was associated with an increase in supportive and a decrease in undermining coparenting behavior over time. In contrast, greater father involvement in caregiving was associated with a decrease in supportive and an increase in undermining coparenting behavior. Multigroup analysis further showed that these cross-lagged relations did not differ for dual-earner families and single-earner (father) families, but these relations appeared to differ for families with focal daughters and families with focal sons. These findings highlight the potential for fathering to affect coparenting and the importance of the role of contextual factors in coparenting-fathering relations.     

Family Functioning and the Course of Adolescent Bipolar Disorder

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age = 14.48 ± 1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents’ depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents’ manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.     

EMPLOYER SUPPORTED CHILD CARE, WORK/ FAMILY CONFLICT, AND ABSENTEEISM: A FIELD STUDY

This study examined the relations among employer supported child care, work/family conflict and absenteeism. No support was found for the hypothesis that use of a child care center at work would reduce the amount of work/family conflict and absenteeism of employed parents. Consistent with our hypotheses, the results indicated that supportive supervision and satisfaction with child care arrangements (regardless of location) were related to less work/family conflict. Further, it was found that less work/family conflict was related to lower levels of absenteeism. The results have implications for the role of employers in addressing child care concerns of employees.     

Depressive symptoms over time in women partners of men with and without alcohol problems

In a sample of 202 adult women and their families, the authors examined the effects of their male partners' alcohol problems and antisociality, the women's alcohol problems and antisociality, family conflict, and offspring behavioral problems on the women's depressive symptoms over a 3-year period. The women's antisociality and alcohol problems were more strongly related to family conflict, offspring behavioral problems, and the women's depressive symptoms than were the men's antisociality and alcohol problems. The women's antisociality and family conflict most strongly predicted increases in the women's depressive symptoms over time. In addition, family conflict mediated the effects of maternal antisociality on the women's depressive symptoms.     

Children growing up in a violent community: The role of the family

This review evaluates empirical reports of relations among exposure to violence in the community, dimensions that characterize families and parenting, and the distress and maladjustment of children and adolescents. Family functioning variables that have been examined in relation to community violence exposure include family conflict and violence, social support, structure and cohesion, parenting practices, maternal distress, and sociodemographic characteristics. Evidence is reviewed for three hypotheses regarding family dimensions: (1) that they are associated with children's community violence exposure in bivariate relations, (2) that they moderate relations between community violence exposure and child outcomes, and (3) that they mediate relations between community violence exposure and child outcomes. Following the empirical review, theoretical and methodological gaps in the literature are identified; guidelines are proposed for ecologically valid family-based research on community violence.     

A two wave cross‐lagged study of work‐role conflict,work‐family conflict and emotional exhaustion

By using a two‐wave panel design, the present study aimed to study causal, reversed, and reciprocal relations among work‐role conflict, work‐family conflict, and emotional exhaustion. The Conservation of Resources theory was applied as a theoretical framework. The study was conducted in a large Norwegian oil and gas company (n = 1703). The results demonstrated positive cross‐lagged effects of work‐role conflict and work‐family conflict on emotional exhaustion. In addition, emotional exhaustion predicted work‐family conflict over time, and work‐family conflict predicted work‐role conflict over time, indicating the presence of reciprocal effects. The current study adds new knowledge to the positioning of work‐family conflict in relation to perceived conflict in the workplace and emotional exhaustion.     

Resilience in Remarried Families

The present study aims to identify those resilience factors that enable remarried families to withstand and rebound from the disruptive challenges they face. A parent and a child from 38 families independently completed seven questionnaires and answered an open-ended question. The following resilience-associated factors were identified: (1) supportive family relationships, (2) affirming and supportive communication, (3) a sense of control over outcomes in life, (4) activities and routines that help the family to spend time together, (5) a strong marriage relationship, (6) support from family and friends, (7) redefining stressful events and acquiring social support, and (8) spirituality and religion within the family.     

Work Family Conflict Among Parents of Atypically Developing Children: Exploring the Impact of Worker,Work, and Child Factors

The purpose of this research was to examine the impact of worker characteristics (e.g., time spent caring for others), workplace support, and child characteristics on work family conflict among parents of atypically developing children. Participants (N = 51) were employed parents of atypically developing children who completed measures of work family conflict, workplace supports (i.e., supervisory support and organizationally supportive cultures), the availability and use of family supportive workplace programs, child characteristics, and worker characteristics. Hierarchical multiple regression analyses indicated that worker and child characteristics significantly predicted work family conflict, work in family interference, and family in work interference. In addition, workplace supports significantly predicted work family conflict and family in work interference. Implications of the results for managing the work family life interface are discussed.     

Parental marital conflict and divorce,parent‐child relationships,social support,and relationship anxiety in young adulthood

Based on research documenting harmful long‐term consequences of parental conflict and divorce for offspring, relations between recollections of parental conflict, parental divorce, and social outcomes in young adulthood were examined. A total sample of 566 young adults from divorced and intact families completed measures of parental conflict, quality of parent–adult child relationships, anxiety in relationships with others, and perceptions of social support from others. As hypothesized, divorce and conflict had significant independent effects on outcomes in young adulthood. Effects of conflict were uniformly negative for quality of parent‐child relationships, perceived social support from others, and anxiety in personal relationships. Parental divorce was associated with lower quality father‐child relationships, yet divorce was associated with significant positive outcomes for quality of mother‐child relationships, social support, independence facilitated by both parents, and reduced anxiety in relationships. Importantly, these effects occurred regardless of participant sex, parental remarriage, and parental socioeconomic status.     

Responses to interpersonal conflict among young adults: Influence of family of origin

This study aimed to examine the role of family environment upon responses to interpersonal conflict in young adulthood, and to determine whether response patterns differed between men and women. Behavioral, affective, and cardiovascular responses of 17 young adults from families rated extreme (EXT) on scales of cohesion and flexibility were compared with those of 21 young adults from balanced (BAL) families. Participants engaged in 2 role‐play conflicts, 1 with a male confederate and 1 with a female confederate. Measures of positive and negative verbal and nonverbal behaviors, self‐reported anxiety and anger, and heart rate and blood pressure were obtained. Results showed EXT participants exhibited more negative verbal and less positive verbal behavior during both interactions than BAL participants. EXT men exhibited greater DBP, state anger, and negative nonverbal responses than BAL men, findings not observed for women. These findings indicate that exposure to a negative family environment influences how young adult men respond to interpersonal confrontation more than young adult women.     

The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment

This study examined the interplay between interparental conflict and child cortisol reactivity to interparental conflict in predicting child maladjustment in a sample of 178 families and their kindergarten children. Consistent with the allostatic load hypothesis (McEwen & Stellar, 1993), results indicated that interparental conflict was indirectly related to child maladjustment through its association with individual differences in child cortisol reactivity. Analyses indicated that the multimethod assessment of interparental conflict was associated with lower levels of child cortisol reactivity to a simulated phone conflict between parents. Diminished cortisol reactivity, in turn, predicted increases in parental reports of child externalizing symptoms over a 2-year period. Associations between interparental conflict, child cortisol reactivity, and child externalizing symptoms remained robust even after demographic factors and other family processes were taken into account.     

Relations between Big Five personality characteristics and perceived support in adolescents' families

The authors investigated the longitudinal relations between family members' Big Five personality factors and perceived support. Members of 285 two-parent families with 2 adolescent children judged their own and other family members' Big Five factors and the support perceived from the other members on 3 occasions at 12-month intervals. The Big Five factor Agreeableness was particularly related to perceived support. Changes in individuals' Big Five factors were linked to changes in the support they perceived themselves but even more to changes in the support that other family members perceived from them. Results are consistent with the parallel continuities hypothesis: Individual characteristics will be stable when there is stability in the supportive environment, but when the environment is changing, personality tends to change in the same direction, and vice versa.     

A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder

Impairments in family functioning are associated with more severe depressive and manic symptoms, earlier recurrences, and more suicidal behaviors in early-onset bipolar disorder. This study examined whether family-focused treatment for adolescents (FFT-A) with BD I or II disorder led to greater increases in family cohesion and adaptability and decreases in conflict over 2 years compared to a briefer psychoeducational treatment (enhanced care, EC). Participants were 144 adolescents (mean age: 15.6 ± 1.4 years) with BD I or II with a mood episode in the previous 3 months. Adolescents and parents were randomized to either FFT-A (21 sessions) or EC (three sessions). Patients received guideline-based pharmacotherapy throughout the 2-year study. Trajectories of adolescent- and parent-rated family cohesion, adaptability, and conflict were analyzed over 2 years. FFT-A had greater effects on adolescent-rated family cohesion compared to EC over 2 years. Participants in FFT-A and EC reported similar improvements in family conflict across the 2 years. In the FFT-A group, low-conflict families had greater adolescent-rated family cohesion throughout the study compared to high-conflict families. High-conflict families in both treatment groups tended to show larger reductions in conflict over 2 years than low-conflict families. Family psychoeducation and skills training may improve family cohesion in the early stages of BD. Measuring levels of family conflict at the start of treatment may inform treatment responsiveness among those receiving FFT-A.