Can the Family Assessment Device (FAD) Be Used with School Aged Children?

This article examines the usefulness of the Family Assessment Device(FAD) in assessing family functioning with school-aged children (under 12 years of age) compared to children 12 and older and mothers. FAD reports from 194 children with asthma (132 under 12 years; 62 12 years and older) were evaluated in comparison to mothers' FAD reports as well as mothers' reports on two other family functioning measures: the Family Inventory of Life Events (FILE) and the Impact on Family (IOF) scale, both relevant to functioning in families with children with asthma. Although FAD scale reliabilities were lowest in younger children (alpha = 48-.79), good concurrent validity was found with mothers' reports on the three different measures of family functioning. Older childrens' FAD scales showed good reliability (> .70) but poorer agreement with the various maternal measures. With modifications to make items more structured and simplified, the FAD could be tried with younger children, although documentation of improved reliability is needed before more widespread use with school-aged children is advocated. The measure already shows good agreement with maternal report in this younger age group, which likely would be strengthened with improved reliability. FAD reports in older children correlated less well with maternal measures, but may represent nonredundant information on family health from an independent perspective and are worth considering in addition to mothers' perspectives.     

The Beavers Systems Model of Family Functioning

Family competence and family style are the two main dimensions of the Beavers Systems Model of Family Functioning. The competence dimension ranges from optimal through adequate, midrange and borderline to severely dysfunctional. The style dimension ranges from centripetal to centrifugal. When the two dimensions are combined, they diagramatically define nine distinct family groupings, three of which are relatively functional and six of which are thought to be sufficiently problematic to require clinical intervention. A family's status on the competence and style dimensions may be established with the Beavers interactional scales. The self-report family inventory may be used to evaluate family members' perceptions of their status on the competence dimension. The reliability and validity of the self-report instrument and observational rating scales have been documented in over thirty papers and books published by the Beavers research team since 1970. The model has proved useful in training, research and clinical work.     

Family Assessment Measure (FAM) and Process Model of Family Functioning

This paper provides an overview of twenty years' work in the development of the Family Assessment Measure (FAM), based on the Process Model of Family Functioning. The Process Model describes a conceptual framework for conducting family assessments according to seven key dimensions: task accomplishment, role performance, communication, affective expression, involvement, control, values and norms. The FAM provides measures of these dimensions at three levels: whole family system (general scale, fifty items), various dyadic relationships (dyadic scale, forty-two items) and individual functioning (self-rating scale, forty-two items). In addition, the general scale includes social desirability and defensiveness response style measures. Brief FAMs (fourteen items) are available for each scale as well. The measurement properties of FAM have been evaluated in a variety of clinical and non-clinical settings. Reliability estimates are very good in most contexts. FAM's validity has been supported using a number of techniques. Overall, the weight of the evidence is that FAM's effectively and efficiently assess family functioning and provide strong explanatory and predictive utility. This empirical evidence reinforces experiences of clinicians, indicating that FAM provides a rich source of information on family functioning.     

Factorial and construct validity of the revised short form integrative psychotherapy alliance scales for family, couple, and individual therapy

The Integrative Psychotherapy Alliance model brought an interpersonal and systemic perspective to bear on theory, research, and practice on the psychotherapeutic alliance. Questions have been raised about the independence of the theoretical factors in the model and their operationalization in the Individual, Couple, and Family Therapy Alliance Scales. This paper presents results of a confirmatory factor analysis of the scales that delineated at least three distinct interpersonal factors as well as shorter versions of the three scales to facilitate their use in research and practice. The paper also presents the results of a study testing each factor's association with client retention and progress over the first eight sessions in individual and couple therapy. At least two of the interpersonal factors were uniquely associated with progress in individual and couple functioning. Implications of the results for theory, research, practice, and training in individual, couple, and family therapy are elaborated.     

Cross-national validity of dimensions of family functioning: First experiences with the Dutch version of the McMaster Family Assessment Device (FAD)

The present study describes the first psychometric findings obtained in The Netherlands with the Dutch version of the Family Assessment Device (FAD) which was originally developed in the Anglo-American cultural context. In a sample of community volunteers, confirmatory analysis (multiple-group method) provided evidence of factorial validity of the FAD measuring constructs. Only 3 out of 60 items were found to be biased and had to be deleted from their a priori defined scales. Reliability and homogeneity indices pertaining to each FAD dimension were good. Despite (very) high correlations among FAD factors/scales, further analyses were focused on determining their convergent and divergent validity which offered good support for such. A higher-order analysis which incorporated reliable scales of the FAD and the Family Environment Scale yielded a two-factor composition: General Family Functioning and Family Influence / Power and Integration. There was evidence to support the viewpoint that a general measure of family functioning may be utilized which is broader in terms of content than the already existing subscale measure termed General Functioning. In line with findings pointing to the ability of the FAD to distinguish between families of psychiatric patients and nonclinical families, the great majority of the FAD subscales, especially Problem Solving and General Functioning, were found to correlate with psychological symptom states as assessed with the Symptom Checklist-90-R. Specific subscales were found to be affected by educational level, while none were affected by sex, age, or religious affiliation. All in all, the findings confirm the further use of the FAD in the Dutch national context.     

Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population

Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n?=?180) and in a normal population (n?=?614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.     

Changing Me,Changing Us: Relationship Quality and Collective Efficacy as Major Outcomes in Systemic Couple Therapy

We examine the sensitivity to change in the Evaluation of Social Systems (EVOS) scale, which assesses relationship quality and collective efficacy. In Study 1 we conducted a waitlist‐control, short‐term couple therapy RCT study (N = 43 couples) with five systemic therapy sessions treating communication and partnership problems; our intent was to provide high external validity. Construct validity of EVOS was assessed by comparison with additionally applied scales (Family Scales; Outcome Questionnaire, OQ‐45.2). In Study 2, N = 332 individuals completed an experiment with high internal validity in order to verify sensitivity to change in three different social contexts. Results from Study 1 revealed a significant increase in relationship quality in the treatment group directly after treatment, as compared to the control group. Sensitivity to change was slightly better for EVOS than for other measures. While this positive change could not be fully sustained between posttreatment and a 4‐week follow‐up, EVOS score did not fall below baseline and pretreatment levels, supporting moderate‐to‐large sensitivity to change. Study 2 supported high sensitivity to change in EVOS for couple relations, family relations, and work‐team relationships. Therefore, EVOS can be used as an outcome measure to monitor the process of systemic interventions focusing on relationship quality and collective efficacy. Due to its sensitivity to change, EVOS can provide evidence for treatment success with regard to relationship aspects.     

Factorial and Construct Validity of FACES IV Among Italian Adolescents

The aims of this study were to evaluate the reliability, validity and factorial structure of Family Adaptability and Cohesion Evaluation Scale, Version IV (FACES IV), investigate the relevance of sex and age on family functioning and study the relationship between family functioning and adolescents’ perception of parent and peer attachment. The sample consisted of 1,416 participants (672 women, 744 men, M_age = 17.38 years; age range = 13–22 years) divided into three age groups: 13–15, 16–18, and 19–22 years. Factor analysis confirmed the dimensions formulated to define the construct of family functioning: all the items of each dimension were loaded in the same factor with a correlation of at least 0.30. Groups differed with regard to the age on Cohesion, Enmeshed and Rigid scales: Younger adolescents (age 13–15 years) showed significantly higher scores than adolescents (age 16–18 and 19–22). Sex differences revealed that females had a higher mean score on Cohesion and Flexibility, whereas males had a higher mean score on Disengaged, Enmeshed and Chaotic. Correlations between FACES IV and Parent and Peer Attachment Scale demonstrated the convergent validity of the FACES IV. Data confirmed the validity of FACES IV’s Italian version and suggested that the Circumplex Model has a cross-cultural applicability and it could be a useful instrument in the Italian context.     

Incremental validity of the MMPI-A content scales in a residential treatment facility

The current study explores the incremental validity of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) content scales. Participants were 335 adolescents (250 boys and 85 girls) between the ages of 13 and 18 who were receiving mental health services from a residential treatment facility. Regression analyses were conducted to identify the amount of additional variance accounted for by the content scales over the clinical scales in predicting scores on a clinician rating form of psychological symptomatology. Several of the MMPI-A content scales demonstrated significant incremental validity above the clinical scales in predicting clinician ratings of adolescents' behavior and personality characteristics. The clinical scales also demonstrated incremental validity in reference to the content scales, indicating then that the two sets of scales provide complementary information. Magnitude of the additional criterion variance predicted was modest.     

Validity and Reliability of Three Rating Scales to Assess Practitioners’ Skills to Conduct Collaborative,Strength-Based,Systemic Work in Family-Based Services

This study analyzed the reliability and validity of three rating scales designed to assess practitioners’ skills in conducting systemic, collaborative, and strength-based assessments and interventions with multi-challenged families in family-based community services. The three scales, which assess reception and assessment skills, basic skills, and skills to support change, revealed good psychometric properties considering their construct validity, internal consistency, and inter-rater agreement. The results are discussed considering future research and possible applications of the scales in research and practice.     

Early emotional instability,prosocial behaviour,and aggression: some methodological aspects

The internal consistency of Emotional Instability, Prosocial Behaviour, and Aggression scales was examined in elementary school children aged between 7 and 10 years. Multiple informants (self-report, teacher rating, mother rating, and peer nomination) were obtained on the above three dimensions. Relationships between the scales were first examined within the single informant frame of reference and then between informants. The concurrent validity was assessed using sociometric measures (popularity, rejection, social impact, and social preference) and the Achenbach and Edelbrock Child Behavior Checklist (teacher and parent form). The results confirm the internal validity of the three scales measuring emotional instability, prosocial behaviour, and aggression in child self-report, teacher rating, and mother rating. The use of self-report measures seems promising within the multiple informant strategy of research on child behaviour. Correlational results show satisfactory concurrent validity for the three scales, especially for teacher rating and peer nomination. The strict relation between emotional instability and aggression poses problems of discriminant validity which need to be further investi gated.     

Scale Imposition as Quantitative Alchemy: Studies on the Transitivity of Neuroticism Ratings

It is common practice in psychology to devise “measurement” procedures by imposing rating scales (e.g., Likert items) onto phenomena and treating the values they produce as quantities. The validity of these procedures goes untested. Validity checks are instead performed on sets of these measurement procedures (i.e., multi-item scales). We present results from three studies suggesting that people cannot be assumed to preserve transitivity when comparing themselves and others on NEO Neuroticism-domain trait items. As transitivity is one of the fundamental axioms of quantitative measurement, these studies challenge the validity of Neuroticism scales at the level of individual scale items.     

Factor analyses of the family assessment device

The Family Assessment Device (FAD) operationalizes the McMaster Model of Family Functioning, which has been used in numerous studies, translated into seven languages, and is regarded as one of the most researched family assessment tools available. However, exploratory and confirmatory factor analyses using the 7-by-7 matrix of subscale correlations from the original validity study on the FAD (Epstein, Baldwin, & Bishop, 1983) indicated that the FAD subscales overlap substantially and do not assess unique dimensions of family functioning. Results of our study suggest that the conservatively best use of the FAD is using the General Functioning subscale as a summary score. A model that fits the data marginally better than the General Functioning score and a Measurement Error model, however, consisted of "Collaboration" and "Commitment" latent factors. These results illustrated the need for more extensive validity research on the FAD, because interpretation of the factors and subscales had to rely heavily on face validity.     

The Investment Model Scale: Measuring commitment level,satisfaction level,quality of alternatives,and investment size

Three studies evaluated the reliability and validity of the Investment Model Scale, an instrument designed to measure four constructs, including commitment level and three bases of dependence–satisfaction level, quality of alternatives, and investment size. In all three studies, reliability analyses revealed good internal consistency among items designed to measure each construct. Also, principal components analyses performed on scale items revealed evidence of four factors, with items designed to measure each construct loading on independent factors. Studies 2 and 3 examined associations of model variables with instruments measuring diverse qualities of relationships and assorted personal dispositions. As anticipated, Investment Model variables were moderately associated with other measures reflecting superior couple functioning (e.g., dyadic adjustment, trust level, inclusion of other in the self), and were essentially unrelated to measures assessing personal dispositions (e.g., need for cognition, self-esteem). In addition, Study 3 demonstrated that earlier measures of Investment Model variables predicted later levels of dyadic adjustment and later relationship status (persisted vs. ended). It is hoped that the existence of a reliable and valid Investment Model Scale will promote further research regarding commitment and interdependence in ongoing close relationships.     

Rating scales for hyperactivity: Concurrent validity,reliability, and decisions to label for the Conners and Davids abbreviated scales

Rating scales have become the instrument of choice in labeling and assessing change in behavior of hyperactive children. However, several criticisms have recently have levied against their use. The present investigation examined the concurrent validity, and inter- and intrarater reliability for the Abbreviated Teacer Questionnaire (ATQ, Conners, 1973) and the Rating Scales for Hyperkinesis (Davids, 1971). Sixteen teachers from two special and two regular schools (grades 1-4) rated 211 normal and 49 special children using both scales. High correlations were found suggesting excellent predictability between scales and considerable stability across time and rater. Lower scores on a subsequent rating relative to an initial rating were demonstrated, dependent on time between ratings but independent of (a) teacher expectation of treatment gains, (b) bias produced by rating selected children, and (c) whether children were hyperactive or normal. Use of initial and infrequent rating scores versus subsequent, closely spaced ratings was related to the rater's objective (e.g., diagnosis, treatment, or assessment).     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

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.     

Factor structure of the Friends and Family interview

The aim of this study was to specify the latent construct structure of the Friends and Family Interview (FFI: Steele & Steele, 2005) based on its dimensional scale coding protocol. The FFI is a semi-structured interview measuring attachment in middle childhood. We analyzed data from 341 FFI interviews with children aged 7–12 years, recruited in the Scandinavian Öresund Region. Exploratory Factor Analysis revealed a three-component model as best fitting the data. The first component, denoting attachment security, gathered all dimensional scales for evidence of secure base/safe haven regarding mother/father and coherence in the child’s narrative style, along with scales regarding reflective functioning, self-perception, and social functioning. The second component comprised preoccupying feelings of anger, but also derogation. The third component gathered all scales coding idealization. Inter-relations among the components were consistent with attachment theory, and respondents’ scores for all three components differed significantly across the four categorical attachment classifications. Affect regulation of negative emotion through anger and through derogation co-occurred, and was distinct from regulation through maintaining a belief that things are better than they appear (idealization). These two affect regulation strategies appeared commonly when reflective functioning, and an organized self-perception, and positive peer relations were less in evidence. The multi-dimensional FFI coding system appears to measure successfully these diverse features of the child’s narrative provided in response to the interview. Overall, our findings support the construct validity of the FFI and provide further evidence of its usefulness for assessing attachment in middle childhood and early adolescence.     

Judgmental relativism as a validity threat to standardized psychiatric rating scales

Judgemental relativism is a threat to the replicability and validity of measures of client behavior from direct rating scales whenever raters are exposed to different levels of client functioning since the internal standards, or anchor points, used to judge dimensional continua may vary on the basis of prior experience. Traditional interrater reliability indexes fail to identify such effects. The influence of judgmental relativism on summated ratings from the Nurses Observational Scale for Inpatient Evaluation (NOSIE-30) for 1040 adult mentally ill clients was examined with clinical staff raters from 24 treatment units in which the Time-Sample Behavioral Checklist (TSBC) provided full-week objective measures of actual client functioning via hourly direct observational coding (DOC). Regression analyses found that the same level of objective performance received higher or lower ratings across treatment units dependent on the raters'exposure to client groups that differed in level of functioning. Analyses of rating errors found that clients with better levels of functioning relative to others within treatment units were rated even higher than performance warranted. The operation of halo and contrast effects is explored and guidelines are provided for determining when judgmental relativism may produce or nullify significant differences. DOC assessments should be used instead of retrospective ratings to support most decisions in residential settings. Specific recommendations for the application of rating scales and improving data quality are provided.This study was the basis of a master's thesis at the University of Houston by Betty E. Rich under the direction of Gordon L. Paul and Marco J. Mariotto. Richard M. Rozelle, to whom appreciation is expressed for helpful comments, served on the examination committee. This study was partially supported by grants to Gordon L. Paul from the National Institute of Mental Health, Public Health Service (MH-15353; MH-25464); the Illinois Department of Mental Health and Developmental Disabilities; the Joyce Foundation; the MacArthur Foundation; the Owsley Foundation; the Cullen Foundation; and the Center for Public Policy, University of Houston.