The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.     

Mental Illness and Psychiatric Treatment Among Women: A Response

Two of Gove's points are given major consideration. First, his precise definition of mental illness is criticized because it excludes diagnostic groups comprised largely of males (personality disorders and substance abusers). Second, Gove's analysis of the value of traditional versus nontradi-tional therapy for women is challenged and support is offered for the role of feminist therapy. It is recommended that the relationship between sex roles and emotional problems be examined and that less emphasis be given to demonstrating that one sex has more problems than the other.     

Paternal and Maternal Influences on Family Functioning Among Hong Kong Chinese Families

The linkages between dyadic relationships in the family and family functioning were examined in 378 Chinese families on two occasions. The following dyadic relationships were investigated: (a) parent-child relationship qualities reported by adolescent children (questionnaire and interview measures of parenting style, parent-adolescent conflict, parent-adolescent communication, and parent-adolescent relationship) and by their parents (questionnaire measures of parent-child relationship quality and demand); and (b) marital quality reported by the parents via questionnaire measures. Results showed that parents' and children's views of family functioning were longitudinally related to dyadic relationships in the family. Relative to mother-adolescent relationship and mothers' report of marital quality, father-adolescent relationship and fathers' report of marital quality were generally found to have a stronger association with perception of family functioning and its change over time.     

Parental Behavioral Control and Parent-Child Relational Quality Predictors of Perceived Parental Knowledge in Chinese Adolescents in Hong Kong

Over three consecutive years, 2,559 Chinese adolescents (mean age = 12.65 years at Wave 1) responded to instruments assessing their perceived parental behavioral control (parental knowledge, expectation, monitoring, discipline, and demandingness) and parent-child relational qualities (satisfaction with parental control, child's readiness to communicate with the parents, and perceived mutual trust between parents and their children). Amongst the various indicators of behavioral control, monitoring was the strongest predictor of parental knowledge. Although parental monitoring and child's readiness to communicate with parents were significant predictors of parental knowledge, parental monitoring was a stronger predictor. Results further showed that behavioral control and parent-child relational quality composite scores were concurrently and longitudinally related to parental knowledge. The present study clarifies the family predictors of parental knowledge in Chinese families, but the findings are not entirely consistent with the Western research findings.     

Family Functioning and Mental Illness: A Comparison of Psychiatric and Nonclinical Families

The primary objective of the present investigation was to examine adaptive functioning in the families of patients with a wide range of psychiatric disorders. Seven dimensions of family functioning, as measured by the Family Assessment Device (FAD), were compared across families of patients with a schizophrenia spectrum disorder (n = 61 ), bipolar disorder (n = 60 ), major depression (n = 111 ), anxiety disorder (n = 15 ), eating disorder (n = 26 ), substance abuse disorder (n = 48 ), and adjustment disorder (n = 46 ). Families in each psychiatric group were also compared to a control group of nonclinical families (N = 353 ). Results indicated that regardless of specific diagnosis, having a family member in an acute phase of a psychiatric illness was a risk factor for poor family functioning compared to the functioning of control families. However, with few exceptions, the type of the patient's psychiatric illness did not predict significant differences in family functioning. Thus, having a family member with a psychiatric illness is a general stressor for families, and family interventions should be considered for most patients who require a psychiatric hospitalization for either the onset of, or an acute exacerbation of, any psychiatric disorder.     

Family functioning of Chinese families in an impoverished neighborhood in Hong Kong

Consonant with the family stress model, in this study family economic disadvantage, concomitant with cumulative family stressors, concurrently contributed to poor family functioning of 504 Chinese families in an impoverished neighborhood in Hong Kong, in which the latter factor appeared to be more pronounced. Implications were briefly discussed.     

Psychometric properties of the Chinese Family Assessment Instrument in Chinese adolescents in Hong Kong

This paper reports evidence on the factor structure, reliability, and validity of the Chinese Family Assessment Instrument (C-FAI), an instrument developed to assess family functioning in Chinese populations. A convenience sample of 1,462 adolescents from junior secondary schools completed the C-FAI and measures of parent-adolescent conflict. Exploratory and confirmatory factor analyses showed that five factors were abstracted from the scale, a finding which was similar to those reported in previous validation studies. Results also showed that the C-FAI was internally consistent and its scores were moderately correlated with measures of conflict with parents, providing support for the convergent validity of the measure. Finally, females perceived family functioning to be better than did males and age was linearly related to perceived family dysfunction. In conjunction with the previous findings, the present study suggests that the C-FAI can be used to objectively assess family functioning in Chinese adolescents.     

Family Strain and Adolescent Delinquency in Two Chinese Cities,Guangzhou and Hong Kong

Elucidating the conditions in which family strain takes effect in adolescent delinquency is one avenue along which to substantiate general strain theory. These conditions include family relationship and the type of delinquency. In the context of Chinese societies, the conditions also include the differences between socialist, collectivist Mainland China and capitalist, more individualist Hong Kong. We collected survey data from 1,026 secondary school students in Guangzhou in Mainland China, and from 1,116 in Hong Kong, to demonstrate these conditions. The results, which indicate the intimate relationship between parents and adolescents, verify that family strain has a very strong impact on adolescent delinquency. In this connection, family strain comprised parental support as a negative indicator. However, the effect of parental support on adolescent strain was only weakly negative in Guangzhou and even positive in the case of nonworking mothers. The differentials in parental influence between Guangzhou and Hong Kong are attributable to the different family policies and structures in the two cities. On the other hand, family strain exhibited similar effects on two types of delinquency, violence and status offense.     

Mental Illness and Psychiatric Treatment Among Women: A Rejoinder to Johnson

In this reply to Johnson, it is suggested that her response to my paper is largely on ideological grounds. Johnson totally ignores the theoretical and empirical basis for the definition of mental illness that is used. She appears not to have read my paper carefully, for all the issues she raises have been dealt with in the paper. She does not seem to comprehend the problematic aspects of both feminist and traditional theory. Johnson does not appear to understand that traditional therapists do not blame the victim and that they also see the therapeutic process as resulting in maturation and growth. Her ideology also apparently makes her unable to see that she and I are in substantial agreement on many issues regarding the role of women.     

Parental, peer, and teacher influences on the social behavior of Hong Kong Chinese adolescents

Intensive interviews and self-report questionnaires were used to investigate parental, peer, and teacher influences on the prosocial and antisocial behaviors of Hong Kong Chinese adolescents. Students came from 5 academically different high schools. Results indicated that perceived parental influence was positively associated with frequency of prosocial behavior and negatively associated with frequency of delinquent behavior. Students with good relationships with their parents and peers showed lower frequencies of antisocial behaviors than did students with bad relationships. Adolescents in different identity statuses (achievement, moratorium, foreclosure, diffusion; E. H. Erikson, 1968) showed different patterns of prosocial and antisocial behaviors. For example, adolescents in the identity achievement group exhibited high frequencies of prosocial behaviors and low frequencies of antisocial behaviors, but those in the identity moratorium group exhibited quite high frequencies of both prosocial and antisocial behaviors.     

Parental,Peer, and Teacher Influences on the Social Behavior of Hong Kong Chinese Adolescents

Intensive interviews and self-report questionnaires were used to investigate parental, peer, and teacher influences on the prosocial and antisocial behaviors of Hong Kong Chinese adolescents. Students came from 5 academically different high schools. Results indicated that perceived parental influence was positively associated with frequency of prosocial behavior and negatively associated with frequency of delinquent behavior. Students with good relationships with their parents and peers showed lower frequencies of antisocial behaviors than did students with bad relationships. Adolescents in different identity statuses (achievement, moratorium, foreclosure, diffusion; E. H. Erikson, 1968) showed different patterns of prosocial and antisocial behaviors. For example, adolescents in the identity achievement group exhibited high frequencies of prosocial behaviors and low frequencies of antisocial behaviors, but those in the identity moratorium group exhibited quite high frequencies of both prosocial and antisocial behaviors.     

The Development and Validation of a Family Wellbeing Index for Hong Kong Chinese Families

Journal of Child and Family Studies - Family wellbeing is studied worldwide. However, there is a dearth of studies on the wellbeing of families in Chinese societies such as Hong Kong, nor is there...     

Mental Illness and Psychiatric Treatment Among Women

When mental illness is precisely defined as a functional disorder involving acute distress or disorganization (or both), women are consistently found to have higher rates of mental illness than men. This sex difference appears to be real and not an artifact of response bias, patient behavior, or clinician bias. The higher rates of mental illness among women can be linked to aspects of their societal role and particularly to aspects of the marital role. Therapists who treat women whose mental illness is in part a response to the characteristics of conventional sex roles have no treatment alternatives that are not in some way problematic. The treatment alternative chosen has, in the broadest sense, political implications for the society at large.     

Optimism and Coping with Unemployment among Hong Kong Chinese Women

The effects of dispositional optimism and coping on the link between unemployment and psychological health were studied among 79 employed and 104 unemployed Hong Kong Chinese women. Results indicated that optimism, indexed by the Chinese version of the Revised Life Orientation Test (C-RLOT), moderated the effect of unemployment on psychological health. The less optimistic women were more psychologically impaired by losing their jobs. Among the unemployed women, the more optimistic ones and those who were more able to distance themselves from job loss fared better. Nevertheless, coping did not mediate the connection between optimism and psychological outcomes. These findings suggest that optimism is an important personal resource for coping with unemployment in Hong Kong Chinese, but whether coping mediates the effects of optimism on psychological health or not depends on other contextual factors. Ways to ensure more reliable prediction regarding the connections between optimism, coping and psychological health in future research were discussed.     

Circumplex Model of Family Systems: A Treatment Tool in Family Counseling

The Circumplex Model and its diagnostic inventory, FACES III, are emerging as important tools for the family counselor. The authors describe the model and inventory and illustrate their use through a case study with a multiproblem family.     

Happy Family Kitchen: Behavioral Outcomes of a Brief Community-Based Family Intervention in Hong Kong

Positive psychology interventions commonly involve behavioral exercises to improve psychosocial well-being. Intervention effect on behavior is unclear. The Happy Family Kitchen project, one of the community-based brief intervention projects under The FAMILY: A Jockey Club Initiative for a Harmonious Society, was conducted in Hong Kong to develop and evaluate the effectiveness of a positive psychology family intervention. We have previously reported positive intervention effects on family communication, family well-being, and subjective happiness. This paper aims to explore the effectiveness of the intervention on behavioral outcomes and their associations with psychosocial well-being. A total of 23 social service units organized and conducted intervention programs for 1419 individuals from 612 families in Hong Kong. Each intervention was developed with emphasis on one of five positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at pre-intervention, immediate post-intervention, and 6 weeks and 12 weeks post-intervention. Results showed that family communication time and frequency of meal preparation with family members increased with sustainable small effects up to 12 weeks. Theme-specific behavior change was observed in the gratitude, flow, and happiness interventions, respectively. Family communication time, frequency of eating with family members, and theme-specific behaviors, including gratitude, flow, happiness behavior, health attitude, and health behavior, were positively associated with psychosocial well-being. Qualitative data provided additional evidence of effectiveness with in-depth insights into behavior change. The positive associations between target behaviors and well-being suggest that improvements in well-being as a function of the intervention may be associated with behavior change.     

Mental Health Disparities,Treatment Engagement,and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness: A Review

Mounting evidence indicates that there are mental health disparities in the United States that disadvantage racial/ethnic minorities in medical and mental health settings. Less is known, however, about how these findings apply to a particularly vulnerable population, individuals with severe mental illness (SMI). The aim of this paper is to (1) provide a critical review of the literature on racial/ethnic disparities in mental health care among individuals with SMI; (2) identify factors which may contribute to the observed disparities; and (3) generate recommendations on how best to address these disparities. Specifically, this article provides an in-depth review of sociocultural factors that may contribute to differences in treatment engagement and rates of attrition from treatment among racial/ethnic minorities with SMI who present at medical and mental health facilities. This review is followed by a discussion of specific strategies that may promote engagement in mental health services and therefore reduce racial/ethnic disparities in SMI.