Causal attributions during therapy II: Reconstituted families and parental blaming

A powerful route to understanding communication within the family is provided by identifying and coding the causal attributions they make during family therapy sessions. The analysis of attributions of responsibility reported in the first of these linked papers (Stratton, 2003) is here extended to explore the accounts given by biological, step- and adoptive parents about their children. Some 1799 causal attributions offered spontaneously by the family members during therapy were analysed according to the Leeds Attributional Coding System (Stratton et al ., 1988). Attributional styles that previously have been found to relate to abuse were more common when stepfathers talked about their children, although none of the parents were believed to be abusing their children. The adoptive parents' attributions were more explicit about problems with the children but were more likely to be functional. Stepfathers made substantially more attributions in the form of blaming a child, with the dimensions identifying characterological blaming being especially significant. Alternative styles of attributing which would offer a way of avoiding characterological blaming are presented. Possible causes and consequences of the consistencies in problematic attributing, and the implications for therapy, are discussed.     

Parents' attributions for achieving compliance from attention-deficit-disordered children

Ninety-one parents provided reasons for the compliance and noncompliance of either their attention-deficit-disordered, hyperactive (ADDH) or non-ADDH child in six different situations. These attributions were rated on Weiner's (1979) dimensions of locus, stability, and controllability. While parents used the same categories to explain the reasons for their children's complaince behavior, they used different dimensional ratings for these explanations. Mothers rated attributions for noncompliance as more external than did fathers. Mothers of ADDH children viewed the causes of their children's behavior to be more unstable than did mothers of control children. Also, ADDH parents had lower expectations of achieving future compliance from their child than did non- ADDH parents. Results were discussed in terms of parental experiences, the need to consider an idiosyncratic approach to attributional meaning, and treatment implications.     

An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric disorders. There is also substantial research to suggest that anger can drive blaming attributions. Combining these ideas, this study built on previous psychoeducation interventions through the addition of an acceptance component designed to decrease anger and blaming attributions among family members of those with bipolar disorder. Twenty-eight family members attended a 1-day or 2-evening multifamily group workshop and completed a follow-up assessment 1 week later. At follow-up, participants demonstrated more knowledge about bipolar disorder. Anger, blaming attributions, and number of criticisms remained unchanged. Results of this study are consistent with others in that it is difficult to change EE. Implications for future clinical research in this area are addressed.     

Predicting Treatment Success in Child and Parent Therapy Among Families in Poverty

Behavior problems are prevalent in young children and those living in poverty are at increased risk for stable, high-intensity behavioral problems. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors. However, CPT programs, particularly those implemented with low-income populations, frequently report high rates of attrition (over 50%). Parental attributional style has shown some promise as a contributing factor to treatment attendance and termination in previous research. The authors examined if parental attributional style could predict treatment success in a CPT program, specifically targeting low-income urban children with behavior problems. A hierarchical logistic regression was used with a sample of 425 families to assess if parent- and child-referent attributions variables predicted treatment success over and above demographic variables and symptom severity. Parent-referent attributions, child-referent attributions, and child symptom severity were found to be significant predictors of treatment success. Results indicated that caregivers who viewed themselves as a contributing factor for their child's behavior problems were significantly more likely to demonstrate treatment success. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems were less likely to demonstrate treatment success. Additionally, more severe behavior problems were also predictive of treatment success. Clinical and research implications of these results are discussed.     

The Excitation-Adaptation Model of Pediatric Chronic Illness

This article examines the value of the psychosomatic family model for the study of chronically ill children. Four conceptual problems arise in the discussion of this model: the unidirectional causality of the model; the function of the sick child for the family system; the pathology of the family characteristics; and the disease type. In the present study, we propose (a) that a distinction be made between uncontrolled and controlled forms of disease, and (b) that the family characteristics of "cohesion" and "adaptation" be examined in relation to the parental capacity for problem solving and the acceptance or rejection of the child by the parents. This is shown by means of empirical research. In this empirical study, 20 families with a child suffering from controlled asthma are compared with 20 families with a child suffering from uncontrolled asthma. Contrary to the assumptions derived from the psychosomatic family model, the results show significantly more cohesion and structure in the group with a child suffering from controlled asthma. The findings from this study are integrated in a new model for the study of chronic childhood illness —"the excitation-adaptation model." In this model, two circular processes are emphasized involving (a) the progress of the illness and the way in which parents and child deal with medication and medical advice (therapy compliance), and (b) the factors influencing the therapy compliance on the part of the parents, the family, and the child. By studying these factors in connection with the management of the illness, it should become clear whether family characteristics are adaptive or pathological.     

Causal attributions and blame: associations with mothers' adjustment to the birth of a child with Down syndrome

The main purpose of this study is to explore the associations between causal attributions to others, blaming others and mothers' adjustment to the birth of a child with Down syndrome (DS). Participants (n?=?214) rated causal attributions to others and blaming others, and completed five measures of adjustment: anger, anxiety, depression, parenting stress, and attitudes towards the child. The adjustment of three groups of mothers was compared: (i) those who made no attributions to others (ii) those who made causal attributions but did not blame, and (iii) those who blamed others. Four years after the births of their children with DS, 16% of mothers blamed others and 17% made causal attributions but did not blame others for this outcome. Those who blamed others had higher levels of anger, anxiety, depression, parenting stress and more negative attitudes towards their children with DS than did those who made causal attributions but did not blame, and those who made who made no attributions to others. The adjustment of the latter two groups did not differ. Investigating blame rather than causal attributions may be a more fruitful area for future research aimed at understanding and facilitating adjustment to illness and other negative life events.     

Parent and child causal attributions during clinical interviews

Attributions made by children and their parents for the cause of the child's clinical problem were monitored during assessment interviews. Results support previously observed differences obtained through questionnaires, with parents making more attributions than their children to characteristics of the child. This pattern was affected by variations in interview format. Parents and children differed in the locus of their attributions when interviewed individually, but these differences were not present when families were interviewed with both parents and children present. Implications for the methodology of attribution research with child-clinical populations are highlighted.     

Reconsidering the attribution-adjustment relation following a major negative event: coping with the loss of a child

Field studies have not yet conclusively established how attributions affect adjustment to unanticipated traumatic events. This may be due, in part, to the adoption of several untested assumptions in most prior research. It has usually been assumed that attributional issues are important to people who experience a traumatic event, that such concern is adaptive, and that specific attributions (e.g., self-blame) influence subsequent adjustment. These assumptions were tested with longitudinal data collected over 18 months from 124 parents whose child died of Sudden Infant Death Syndrome. By 3 weeks postloss, 45% of parents were not concerned with attributional issues. These parents were less distressed and less likely to blame themselves or others for the death. Longitudinal analyses did not support the assumption that attributions influence subsequent adjustment. Rather, attributions to onself or others appear to be symptomatic of distress.     

The Self- and Other-Blame Scale (SOBS). The background and presentation of a new instrument for measuring blame in families

This article presents an account of the development and reliability of an observational instrument to measure blame: the Self- and Other-Blame Scale (SOBS). Fifty-one eating disordered patients together with eighty of their relatives were interviewed using a semi-structured family interview. Videotapes were assessed by two independent raters. Inter-rater reliability was good for both dimensions of SOBS: self-blame (SB) and other-blame (OB). One of the aims in developing the instrument was to be able to explore the relationship between self- and other-blame and criticism. Preliminary data are presented showing the distribution of SOBS scores within families rated as high or low on Expressed Emotion (EE). High EE was associated with high levels of self-blame in the parents, but not in the patients. Fathers in high EE families were more blaming of the patient than those in Low EE families but this was not true for mothers' levels of daughter blaming.     

Cognitive-behaviour therapy for marital conflict: refining the concept of attribution

In recent years, the concept of attribution has received increasing attention in the field of cognitive-behavioural marital therapy. Research has found that the attribution dimensions of source, globality, stability, intent and voluntariness are related to marital distress and conflict behaviours. This paper argues that the application of the attribution dimensions has been conceptually problematic, and proposes a distinction between attributions made for a specific conflict episode, a behaviour in an episode and the causal schema for the conflictual relationships. Different reattribution techniques should be employed to target attributional change at appropriate levels of conflict attributions. This proposition is illustrated with a case example.     

Hostile attributional tendencies in maltreated children

The hostile attributional tendencies of maltreated children in elementary school across key relationship figures (i.e., parents, teachers, and peers), the relation between children's hostile attributional tendencies and the frequency and severity of maltreatment, and the role of children's hostile attributions of their parents in mediating the relation between maltreatment and children's hostile attributions of unfamiliar peers were examined. The sample consisted of 44 maltreated and 56 nonmaltreated children (females = 51) of mixed ethnicity. Subjects were administered a 20-item measure of attributional processes. The results indicated that relative to nonmaltreated children, physically abused boys were more likely to attribute hostile intentions to a variety of relationship figures, including their parents, an unfamiliar teacher, their best friend, and unfamiliar peers. A positive relation was also found between the frequency of physical abuse and hostile attributional tendencies among males. Finally, support was found for the role of children's hostile attributions of their mothers in mediating the relation between physical abuse and children's hostile attributions of unfamiliar peers. The results support a link between physical abuse and hostile attributional tendencies in children in early elementary school.     

Relationships of parents’ and child’s general attributional styles to academic performance

This study examined the relationships among student academic performance and child’s and parents’ attributional styles. One hundred seventy-nine students (87 boys and 92 girls) who were enrolled in primary public schools in New South Wales, Australia, and their parents volunteered to participate in the study. Only English-speaking, two-parent families were included. Participants completed age-appropriate attributional style questionnaires. Academic performance was obtained from student records of course grades. The results indicated that both mothers’ and fathers’ attributions for their own positive and negative life events were related to their children’s attributions for their academic performance. We present implications of these results for research on attributions and academic performance.     

Family Communication about Donor Conception: A Qualitative Study with Lesbian Parents

In this qualitative study of 10 lesbian couples who built their families through anonymous donor conception, we explore how lesbian parents experience communication about the donor conception within the family. While for these families “disclosure” of donor conception is often seen as evident, the way parents and children discuss this subject and how this is experienced by the parents themselves has not received much research attention. To meet this gap in the literature, in‐depth interviews with lesbian couples were conducted. An Interpretative Phenomenological Analysis showed that this family communication process can be understood within the broader relational context of parent–child relationships. Even though parents handled this family communication in many different ways, these were all inspired by the same motives: acting in the child's best interest and—on a more implicit level—maintaining good relations within the family. Furthermore, parents left the initiative for talking about the DC mostly to the child. Overall, parents aimed at constructing a donor conception narrative that they considered acceptable for both the children and themselves. They used different strategies, such as gradual disclosure, limiting the meaning of the donor, and justifying the donor conception. Building an acceptable donor conception narrative was sometimes challenged by influences from the social environment. In the discussion, we relate this qualitative systemic study to the broader issues of selective disclosure and bidirectionality within families.     

Depression, self-esteem, and complex attributions for life problems

Past research has suggested that mild and moderate depression are associated with increased attributional processing and a tendency to make complex attributions involving two or more causes. The present research tested the hypothesis that depression and low self-esteem are associated with a tendency to make attributions to multiple causes when faced with life problems. The results were used to demonstrate that the tendency to make multiple attributions for specific life problems accounts for unique variance in depression and self-esteem scores, even after removing variance due to general attributional style. The findings are discussed with reference to the need for multidimensional models of attribution in depression and attributional retraining efforts to include an emphasis on individual differences in the number of multiple attributions made by people.     

Parent and child causal attributions related to the child's clinical problem

Parents and children were asked to give causal attributions related to the child's learning or behavior problems and an area of success. Actor-observer differences and tendencies of actors to make differential attributions for their positive and negative outcomes were examined. A significant number of parents and childen were in disagreement regarding the cause of the child's problem. Parents made significantly more internal than external attributions for children's presenting problems. In contrast, children were evenly distributed in problem attributions. Both parents and children made significantly more internal success attributions. Research with clinical child populations is highlighted as a valuable way to validate, expand, and refine attribution theory while clarifying its practical applications.Portions of the data included here served as the basis for a presentation by the first author at the annual meeting of the American Psychological Association, New York, 1979. The authors wish to thank the Fernald research group for their comments, and the staff of the San Fernando Valley Child Guidance Clinic, the Fernald office staff, and Perry Nelson for assistance.     

The relationship of relatives' attributions to their expressed emotion and to patients' improvement in treatment for anxiety disorders

In a test of Hooley's (1987) attributional model of expressed emotion (EE), attributions for negative behaviors and events in patients' lives were examined in relatives of 74 outpatients with panic disorder with agoraphobia or obsessive-compulsive disorder. Attributions were extracted from 10-minute problem-solving interactions between relatives and patients, whereas EE was assessed during a separate interview with the relative. Consistent with prior findings in relatives of individuals with other disorders, relatives who made greater proportions of attributions of patient responsibility demonstrated significantly higher levels of EE-hostility. In addition, nonspousal relatives (mostly parents) who attributed any negative behaviors or events to a patient's disorder were significantly higher in emotional overinvolvement (EOI); no such relationship was found for spouses. Finally, patients with relatives who made attributions to the patient's disorder received less benefit from behavior therapy than did those whose relatives made no such attributions, even when EE variables were controlled.     

The conflict cycle in the case of an adolescent in crisis

This is an extension of a previous paper describing a conflict cycle in families and therapy consisting of four steps: (1) the dispute; (2) blaming; (3) shame, guilt, or denial; and (4) reparation, reconciliation, or retaliation. The focus is on a single case of a 15-year-old male with a gender identity disorder in addition to a conduct disorder. He is an adopted child living in a small community in the southern United States. Conflict is illustrated from several perspectives in a single interview with the family and over the length of contact over a nine-month period: (1) between the adolescent and parents, (2) between the adolescent and community, (3) between the parents, and (4) between the Good Self and the Bad Self of the adolescent. The thesis is that the conflict cycle is an organizing principle helpful to therapists working with families to make assessments and plan interventions.This paper is an expanded and edited version of a presentation by the senior author in San Diego, California, on November 12, 1988, at the Western States Conference of the American Society of Adolescent Psychiatry.     

Do hostile attribution biases in children and parents predict relationally aggressive behavior?

Relatively little is understood about the role of hostile attributions in children's use of relational aggression with peers, or about the impact of family processes on children's attributions about ambiguous provocations. This cross-sectional study investigated associations among hostile attributions made by children, mothers, and fathers, and children's use of relational aggression with peers. The sample included 91 children in Grades 3-5 (43 girls), and their mothers (n = 90) and teachers (n = 88). Fathers also participated for a subsample of children (n = 53). Results showed that relational aggression is associated with a hostile attribution bias in children and parents, although findings varied as a function of gender of parent and child, provocation type, and informant of aggression. Overall, mothers' attributions were more closely related to daughters' attributions and aggressive behavior than to sons'. Implications of these findings for social information processing models and family-focused prevention of relational aggression are discussed.