The product of the consensus Rorschach in families of male schizophrenics.

A consensus Rorschach was given to the families of 36 male schizophrenics, 13 psychiatrically hospitalized nonschizophrenic controls, and 38 normal controls with the goal of discriminating the families of schizophrenics from the other two groups of families. After the family agreed on a response, each member was asked to write the response on a separate sheet of paper. This study focused on these written responses, the product of the interaction, rather than on the process of reaching agreement. A system was developed to score the responses based on the degree of shared meaning achieved by the family. Adequate interscorer reliability was obtained. The scores significantly differentiated the three groups. More families of schizophrenics had low scores indicating lack of shared meaning than families of hospitalized and normal controls. In the normal control group, more upper-class families had high scores than lower-class families, wheras in the schizophrenic group there was a trend in the opposite direction.     

A comparison of obese and normal-weight families' sychological characteristics

Abstract

The present study assessed obese and normal-weight family members' perceptions of their nuclear family's social and environmental characteristics. Preliminary results support previous correlational and case studies that suggest obese families are dysfunctional. Results from the Family Environment Scale indicate that obese families perceive their family characteristics differently compared to normal-weight families or to a representative sample of families. Specifically, obese families perceive their homes as less cohesive, more conflictual, less interested in social and cultural activities, and less organized compared to normal-weight families. Obese parents also perceive themselves as more controlling and their families as less independent compared to nonobese parents.     

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.     

Family context of infantile colic

Psychological factors in families with a colicky baby were studied. A total of 59 families who had enrolled on the basis of information received at the postpartum wards in the city of Turku, Finland, were included in this study. In addition, 58 families with age-matched infants were selected as a control group. These families kept a diary of the infant's crying. Thirty-six infants fulfilled the criteria for severe colic. Twenty-three families with a baby who cried excessively but did not fulfill the criteria were defined as the moderate colic group. A semistructured family interview was carried out to assess the structure, communcation patterns, functioning, and affective tone of the families. Mothers and fathers were younger in the moderate colic group compared with parents in the other groups. In the moderate colic families, the infant was more often the first child than in the control families. On the other hand, neither the infant's gender nor the education of the parents was related to infant's crying. Organized family structure and strong parental coalition were more often present in the severe colic and control groups than in the moderate colic group. Increased family chaos was noted in this group. The severe and moderate colic families had more enmeshed individual boundaries. Generational boundaries were enmeshed in the moderate colic families. Communication patterns did not differ between the groups. The families with a severely or moderately crying baby were less flexible, had decreased ability to cope with daily activities, and showed less energy and vitality than the control families. Both the severe and moderate colic families expressed more anxiety and conflict compared to the control families. In conclusion, an association between infantile colic and psychological characteristics of the family was found. Moreover, the families with a moderately colicky infant had specific psychological features that differed from both the control families and those with severely colicky infants.     

Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes

Family context is thought to influence chronic disease management but few studies have longitudinally examined these relationships. Research on families and chronic illness has focused almost exclusively on European American families. In this prospective study we tested a multidimensional model of family influence on disease management in type 2 diabetes in a bi-ethnic sample of European Americans and Latinos. Specifically, we tested how baseline family characteristics (structure, world view, and emotion management) predicted change in disease management over one year in 104 European American and 57 Latino patients with type 2 diabetes. We found that emotion management predicted change in disease management in both groups of patients as hypothesized, while family world view predicted change in both ethnic groups but in the predicted direction only for European Americans. Examining family context within ethnic groups is required to elucidate unique cultural patterns. Attending to culturally unique interpretations of constructs and measures is warranted. The import of family emotion management, specifically conflict resolution, in disease management deserves further study to support clinical intervention development. Examining multiple domains of family life and multidimensional health outcomes strengthens our capacity to develop theory about family contexts and individual health.     

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

An Approach to Examining the Proximal and Intermediate Outcomes of an Intensive Family Preservation Program

This study examined the effects of the Boys Town In-Home Family Program (BT-IHFP) on parenting skills, family functioning, and child behavior for at-risk families involved with child protective services. The BT-IHFP is designed as a home-based, family-centered alternative to out-of-home placement with the goal of improving family functioning, keeping families together, and preventing further involvement with child protective services. The model uses a hands-on cognitive-behavioral approach, promotes family engagement, provides 24/7 services to families, and links families to community resources. While it is essential to examine ultimate, long-term outcomes such as family preservation, it is also important to investigate the proximal and intermediate outcomes that address the key changes in behavior that support successful long-term outcomes. The goals of this study were to (1) examine the pre-post change of proximal and intermediate outcomes and (2) examine if improvements in parenting skills, parental roles, and parental stress (proximal outcomes) will be related to improvements in child behavior at home, child behavior at school, and family functioning (intermediate outcomes). Inspecting intake and discharge data for 44 families, 94% were intact at discharge and significant pre-post improvements were found in proximal and intermediate outcomes. These findings suggest that this six-week intensive BT-IHFP holds promise for teaching at-risk families skills to promote positive family functioning.     

Post-divorce mother-son relations of delinquent and well-adjusted adolescents

This study exmined the long-term effects of divorce an adolescent boy's relations with their mothers. Eighteen ealry father-absent (before age 5), 18 late father-absent (between ages 5 and 10), and 18 infant families with a delinqunet or a well-adjusted male adolscent were evaluated using observational and self-report measures of mother-son relations, as well as personality measures. Multivariate between-groups comparisons indicated that the relations of divorced mothers and their sons were more conflictive and less warm than were mother-son relations in infant families. Moreover, mother-son relations were least positive ie early father-absent families. Regarless of the intactness of the home, fammilies with a delinquent boy evidenced difficulties in several areas of mother-adolescent relations. These findings suggest that the task of raising an adolescent son in generally more difficult in divorced than in intact families, but that the association between adolescent behavioral maladjustment and mother-adolescent relations is similar across family structures.     

Low-income mothers' patterns of partnership instability and adolescents' socioemotional well-being

The present study investigated the association of family structure and maternal partnership instability patterns with adolescents' behavioral and emotional well-being among urban low-income families. Analyses employed data from the Three-City Study to track maternal partnerships over the youth's life span, linking longitudinal family structure and transition patterns to adolescent well-being (N = 2305). Families were classified into nine mutually exclusive longitudinal partnership groups based on current status at wave 3 (single, married, or cohabiting) and the longevity of that status: always (since adolescent's birth with no transitions), stable (lasting two years or more, preceded by transitions), or new (transpiring in the past 2 years). Adolescents in the always married group displayed less delinquency and externalizing problems, according to both youth and mother reports, than peers in always single-parent or newly married households. In contrast, youth in always cohabiting households had higher maternal ratings of internalizing problems and youth with newly cohabiting mothers reported higher psychological distress than peers in similar stability groups with single or married mothers. Overall, several potential explanatory processes for the family structure and stability patterns surfaced: married parent families reported less economic hardship, more family routines and father involvement, and less maternal psychological distress and parenting stress than their single and cohabiting counterparts. Policy implications of these findings are discussed.     

Cost Effectiveness of Strategies for Recruiting Low-Income Families for Behavioral Parent Training

The goal of this study was to assess cost, effectiveness, and cost-effectiveness of recruitment strategies used to engage low-income families of young children with disruptive behavior disorder to participate in a Behavioral Parent Training (BPT) program. For this analysis, we used data on labor and non-labor resources associated with 13 recruitment strategies implemented in February 2014 through February 2016. We assessed the effectiveness of each strategy as the number of families that enrolled into the study. Cost-effectiveness of each recruitment strategy was expressed as cost per family enrolled; analysis was conducted in 2016. We calculated the cost of total recruitment effort for 13 strategies during the 2-year period to be $11,496 with an average cost of $885 per recruitment strategy or $255 per enrolled family. Across strategies, total costs ranged from $25 to $2540. “University mass e-mail” and “school flyers” resulted in the most phone screens (34 each); however, only 10% of these families enrolled in the study (three and four families, respectively). “Craigslist” was the most effective strategy with 30 families screened and 11 of them enrolling. Three strategies did not yield any participants. The four strategies with the lowest cost per family enrolled were “Facebook page,” “Craigslist,” “university mass e-mail,” and “organization/agency” (<$90). In conclusion, we found that some recruitment strategies were more successful at engaging low-income families to participate in a BPT program than others. Our results indicate that using a combination of recruitment strategies may be the optimal approach for recruiting low-income families.     

Parental confirmation as a mitigator of feeling caught and family satisfaction

This study tested parental confirmation as a mitigator of the inverse association between young adults' feelings of being caught and family satisfaction. Participants included 567 young adult children from intact and divorced families. Results indicated that mother's confirmation mitigated the inverse association between feeling caught and family satisfaction for young adults from divorced families. Family satisfaction was lowest in divorced families when young adults felt caught and their fathers were disconfirming, though young adults in intact families reported even less satisfaction in such a communicative context. Importantly, mother confirmation was more predictive of family satisfaction in divorced families than in intact families, whereas father confirmation was more predictive of family satisfaction than mother confirmation for young adults in intact families.     

GENDER, JOB AND FAMILY CONDITIONS, AND PSYCHOLOGICAL SYMPTOMS

This study examined the hypothesis that gender differences in psycho-logical distress are mediated by job and family role conditions. Previous research has failed to directly test such mediational hypotheses but rather has inferred effects of role conditions from simple role-occupancy variables. The sample consisted of full-time employed married respondents including 161 women with full-time employed spouses, 142 men with nonemployed spouses, and 126 men with full-time employed spouses. Although the sample reported low psychological symptomatology overall, the women in dual-earner families reported more psychological symptomatology than did either group of men. Hierarchical regression equations indicated that work and family conditions fully attenuated this gender differential. Women in dual-earner families also reported less job enrichment, less time at work, and more household labor inequity than did either group of men. They also reported more childcare difficulty than did men with nonemployed spouses. Work-family interference predicted psychological symptomatology and partially accounted for its relationship with some job and family conditions. We discuss processes through which gender affects psychological distress.     

Assaultive Adolescents: Family Decision-Making Parameters

This article presents the results of a pilot study that investigated the family decision-making styles of families with a violent adolescent ( 17 ) and families with a normal adolescent ( 12 ). The results, utilizing an unrevealed differences family interactional test, showed that families with an assaultive teenager when contrasted with normal families had: (a) less agreement when making choices as a group; (b) less agreement between mother and violent son when making choices about activities; (c) sons who had less influence in the families' choice of activities; and, (d) mothers who "dictated" the families' decisions more often. The meanings of these findings and others are discussed by the authors as they relate to the problem of assaultive youths.     

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.     

The family check-up: a pilot study of a brief intervention to improve family functioning in adults

Many barriers exist for families seeking appropriate treatment for family problems. In an effort to minimize some of these barriers, we developed the Family Check-Up, a brief two-session family intervention. The Family Check-Up is based on the Drinker's Check-Up and consists of assessment, feedback, discussion, and goal setting. The purpose of the intervention is to help families identify and become motivated to make needed changes in any aspect of their family functioning. We conducted an open pilot trial of the Family Check-Up with 32 families. Our data suggest that the Family Check-Up (1) is sought out by the target audience, namely those with family problems; (2) is sought out by people with elevated depression symptoms or a history of treatment for depression or anxiety; (3) is feasible to conduct; (4) is acceptable to families; and (5) may be associated with changes in family functioning and depression symptoms over time. These results suggest that further research, particularly a randomized clinical trial, is warranted.     

Medical or relational language? Problem and goal formulation in family therapy with adolescents conducted in a psychiatric outpatient setting

The constructionist view assumes that therapy participants' maps of understanding depend on the institutional context and their personal perspectives. The purpose of this study was to investigate the initial maps of difficulties reported by family members starting family therapy. 106 families that were referred to a psychiatric institution for outpatient family therapy were asked open-ended questions regarding the context of the referral, and goal and problem formulation for the therapy. The data were analysed via the consensual qualitative research-modified (CQR-M) method, and comparisons between groups were performed. The obtained results show a diversity of perspectives. Of interest was the predominance of medical language in describing the problem and relational language in describing the goal of therapy. An analysis of differences between mothers, fathers, adolescent patient and their siblings was also performed. The findings highlight the complexity of notions that families start family therapy with and may help therapists navigate through the therapeutic contract formulation process.     

Is knowledge of family history related to psychosocial functioning? Comparison of adolescents living in institutional care and adolescents living with their biological families

We tested adolescents growing up in institutional care and adolescents living with their birth families using the ‘Do you know?’ scale and other measures of psychosocial functioning. We found that children living in group homes knew significantly less of their family history, exhibited more behavioural problems and had a more external locus of control. Moreover, the correlations between self-esteem and knowledge of family history were significantly different between the groups. This may suggest that the contribution of the knowledge of family history to self-esteem is different depending on the quality of family history. We also found a significant correlation between locus of control and behavioural problems for the children in institutional care, but not children living with their birth families, which may indicate that their behavioural problems may partially stem from the sense of lack of control over their lives.