Family stressor events, family coping, and adolescent adaptation in farm and ranch families

Data from 77 adolescents in farm and ranch families were used to examine the relationship of demographic variables, family stressor events, and family coping strategies to adolescent adaptation. Results indicated that adolescent age and family transitions were positively related to individual stress. Males reported less family stress than did females. Seeking spiritual support was negatively related to family stress, while the perceived impact of the farm crisis was positively related to family stress. Family support was positively related, and family substance use issues were negatively related, to adolescent satisfaction with family life. The implications of these findings are discussed.     

The Brief Family Distress Scale: A Measure of Crisis in Caregivers of Individuals with Autism Spectrum Disorders

Parents of individuals with autism spectrum disorders (ASD) often experience stressors associated with caring for their child. These stressors can cause considerable distress for families, which at times can develop into full blown crisis, and it is important that professionals be able to quickly identify when families are approaching or are in crisis to respond appropriately. The current study presents an initial attempt at measuring the subjective experience of crisis in 164 caregivers of people with ASD through a single item instrument, the Brief Family Distress Scale. The BFDS was negatively correlated with helpful coping mechanisms (family hardiness, and parent empowerment), and positive adjustment (caregiver quality of life and positive parenting experiences), and positively correlated with known stressors (severity of aggressive behavior, negative life events) and problematic coping and outcomes (caregiver burden, worry, mental health problems). As expected, caregivers at Marked levels of distress (approaching or in crisis) were significantly different from caregivers at lower levels of distress in nearly all of the dependent variables. Having a quick way of measuring where families are in terms of distress and crisis can be helpful for researchers and clinicians alike.     

Gender responses to psychological distress among Palestinians: Risk and protective factors

This study investigated the extent to which differences in the presence of trauma, political and normative stressors, resources, coping, and hardiness could account for variation in gender responses to psychological distress among Palestinians. Participants were 624 males and females aged 27–56 years. Questionnaires were administered in an interview format with participants at home. Results indicated that female gender has been associated with psychological distress. The females in this study reported feeling distressed by intrafamily strains, whereas males reported feeling distressed by work and family strains as well as losses. Political stressors were more predictive of psychological distress than was the presence of trauma or normative stressors. The sociodemographics had different patterns of relations with psychological distress. Females' education was negatively related to psychological distress, whereas the family income was negatively related to psychological distress in males. No significant differences between males and females were found in their coping responses. However, cognitive and behavioural strategies Family Crisis Oriented Personal Evaluation Scales (F‐COPES) seem to combine and had an impact on psychological distress of females only. Also, family hardiness was evidenced to have an influence on perceived psychological distress in both genders. The clinical and policy implications of these conclusions were discussed.     

Family Resilience and the Management of Fibromyalgia: Implications for Family Therapists

Fibromyalgia Syndrome (FMS) is one of the most troubling rheumatic disorders for patients, significant others, and the health care providers who treat them. Responses from 150 participants provided valuable information on the relationship between family resilience and the management of fibromyalgia. Self reported family stressors, strains, and distress were significantly associated with an increase in health problems/functional disability, whereas family hardiness and family social support were associated with a decrease. Family stressors and family strains were also positively associated with the frequency of medication use. Medical family therapy interventions that consider the familial context are recommended for treatment. Additional implications for clinical practice and future research are discussed. J. Cameron Preece, PhD, Sage Health Care, PLLC, 339 Allumbaugh Street, Boise, ID 83704. Jonathan G. Sandberg, PhD, Department of Marriage and Family Therapy, Syracuse University, Syracuse, NY 13244. (jgandbe@syr.edu) Special thanks go to Linda Stone Fish, PhD, for her support and guidance throughout the study.     

Adult Children of Alcoholics and Psychological Distress

In this study, the author investigated the relationship between parental alcoholism and psychological distress and the mediating effects of social support and hardiness. The sample (N = 228 college students) consisted of n = 62 adult children of alcoholics (ACAs) and n = 166 non-ACAs. Data analysis indicated that parental alcoholism was positively related to psychological distress. Consistent with expectations, higher levels of social support and hardiness were associated with lower levels of psychological distress. No mediating effects of social support and hardiness, however, were found. Implications for current theories and therapeutic approaches that regard ACAs as being at increased risk for psychological distress are discussed.     

Appraisal of life change, depression, and illness in hardy and nonhardy women

A survey study of adult women was conducted to examine whether psychological hardiness buffers people against stressful life change through the appraisal and interpretation of life experiences. Hardy and nonhardy participants reported life events for the previous year, physical illness for the previous 6 months, and current levels of depression and rated each reported event in terms of its desirability. Results indicate that, although hardiness is not associated with the likelihood of reporting any specific life event, nonhardy subjects appraise a significantly higher proportion of their life experiences as undesirable than do hardy subjects and report that each negative event requires greater adjustment. Discussion focuses on nonhardiness as a correlate of the trait of negative affectivity rather than hardiness as a reflection of special resiliency to stress.     

Similar minds in the family: COVID-19 centrality and relationship quality

We examined whether perceived similarity in COVID-19 centrality (i.e., the extent to which one thinks of the pandemic as shaping current and future life) is associated with family relationship quality during the pandemic. Thinking that other family members are similar to oneself regarding the pandemic's centrality may improve the quality of family relationships. We collected data from Turkish family triads (i.e., mother, father, 18–25 years old child) and had 481 participants from 180 families. Participants rated their similarity in COVID-19 centrality with the other two family members and reported the general and daily quality of their relationship with them (relationship satisfaction, closeness, conflict). We analyzed the data using the Social Relations Model. We found that family members who, on average, perceived more similarity in COVID-19 centrality reported higher levels in positive attributes of general relationship quality (i.e., satisfaction and closeness). The effects on conflict and daily relationship quality were less conclusive. This research confirms that family members' reactions during the COVID-19 pandemic are interdependent. Perceiving that other family members are of similar minds about the centrality of the pandemic relates positively to some aspects of relationship quality.     

Parents’ Perceptions of Functioning in Families Having a Child with a Genetic Condition

In a study of families having a child with a genetic condition, patterns of family functioning were identified through cluster analysis of families with two spouses. Patterns were based on both parents’ assessments of family satisfaction and hardiness, as measured respectively by the Family APGAR and Family Hardiness Index. The validity and clinical significance of the clusters were supported by demonstrating that cluster membership distinguished between parental reports of their own quality of life and their child’s functional status, as measured by the Quality of Life Index and the Functional Status II, respectively. The clusters were non-categorical in the sense that they did not depend on the type of genetic condition. These findings point to the importance of addressing family functioning as part of genetic counseling.     

Resilience in Families that have Experienced Heart-Related Trauma

The aim of this study was to identify resilience qualities in families in the wake of heart-related trauma of one of their members. The theoretical framework of this study was the Resiliency Model of Family Stress, Adjustment and Adaptation, which represents a paradigmatic shift from a pathological to a strength-based view of a family. Self-report questionnaires and an open-ended question were used to collect data from 22 family members who experienced the heart-related trauma. The results indicate that family time and routines, parent–child togetherness, family chores and affirming communication are key qualities for mediating family adaptation, while inflammatory communication was found to be negatively associated with family adaptation. Other relevant qualities were social support, family hardiness and a coping style where problem situations are reformulated. The identification of these qualities can serve as the focus for intervention and prevention, enhancing the quality of life for families with a cardiovascular patient.     

Threat appraisals, distress and the development of positive life changes after September 11th in a Canadian sample

Several surveys have reported the negative psychological impact on the general public of the terrorist attacks in the USA of September 11th, 2001. Yet the attacks also led many people to make positive changes in their relationships, values and priorities. A survey of 80 adults in Ottawa, Canada demonstrated that greater perceived threat and greater initial distress reactions significantly predicted the extent to which people reported positive changes in their lives (e.g. closer to family, refocused priorities). Initial distress and greater perceived threat also correlated positively with whether people provided help after the disaster. Follow-up data on 40 of these participants 11 months later revealed significant stability over time for the extent of positive life changes reported, and demonstrated that degree of initial distress and perceived threat continued to correlate positively with life change reports at this later point in time. The data are consistent with the argument that the perception of growth may develop out of one's personal experience of emotional pain.     

The legacy of parents' marital discord: consequences for children's marital quality

Drawing on a national longitudinal study of 297 parents and their married offspring, the authors found that parents' marital discord was negatively related to offspring's marital harmony and positively related to offspring's marital discord. The transmission of marital quality was not mediated by parental divorce, life-course variables, socioeconomic attainment, retrospective measures of parent-child relationships, or psychological distress. Offspring's recollections of parental discord, however, mediated about half of the association between parents' reports of marital discord and offspring's reports of discord in their own marriages. Parental behaviors most likely to predict problematic marriages among offspring included jealousy, being domineering, getting angry easily, being critical, being moody, and not talking to the spouse.     

Longitudinal associations between parents' hostility and siblings' externalizing behavior in the context of marital discord.

This study examined longitudinal associations between parents' hostility and siblings' externalizing behavior in the context of interparental discord. The sample included 116 families (mothers, fathers, 2 siblings) assessed in middle childhood, when siblings were, on average, 8 and 10 years old, and in adolescence, at average ages of 14 and 16 years. Parents reported on their hostility toward each child and on each child's externalizing problems. Raters observed interparental hostility, and parents rated their marital quality. Results indicated both within-family and between-families effects. Specifically, the child who received more parental hostility than his or her sibling showed greater increases in externalizing problems than his or her sibling; this association was moderated by marital discord. In addition, the child who exhibited more behavioral problems than his or her sibling received greater increases in hostile mothering than did his or her sibling. Between-families effects were evident, in that children's externalizing problems were associated with increases in mothers' hostility toward both children in the family. Results support transactional models of development and family systems theory.     

Affiliative and Instrumental Marital Discord, Mother's Negative Affect, and Children's Negative Interactions with Unfamiliar Peers

Indices of marital discord and mother-child affective processes were used to predict levels of negativity children displayed with unfamiliar peers. Thirty-nine mothers and their 5-year-olds were observed with 5–7 other mother-child dyads during a 30-minute free play session. Mother and child negativity were coded and two types of marital discord were assessed via mother self-report: affiliative discord (e.g., distress due to the lack of affiliative behaviors in the marriage) and instrumental discord (e.g., disagreements about the accomplishment of marital tasks, such as finances, time management, and goal setting). Affiliative discord was found to relate to the child's negativity with unfamiliar peers, but instrumental discord was not. Furthermore, maternal negativity moderated the link between marital discord and child's negativity with peers, such that high levels of affiliative discord combined with heightened maternal negativity was associated with child negativity. Practical implications are discussed.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

The buffering effect of family functioning on the psychological consequences of headache

The current study aimed to examine whether high family functioning mitigates the association between headache intensity and distress. The sample consisted of 124 patients with chronic or recurrent headache. Patients completed validated questionnaires about headache intensity, family functioning, and distress. Hierarchical regression analyses were performed to examine the interaction between headache intensity and family functioning on distress. Headache intensity was positively associated with distress (r = .28, p = .002). As hypothesized, family functioning moderated this association (B = ?.01, p = .023). More specifically, the positive association between headache intensity and distress was significant only among patients with lower family functioning (B = .01, p < .001) and not among patients with higher levels of family functioning (B = .006, p = .075). Functional families appear to buffer the distress level in patients; they showed relatively low levels of distress regardless of the severity of their headache. In contrast, patients with dysfunctional families who experienced more pain reported more distress, presumably because they did not receive adequate help and support from these families. This study underlines the importance of a broader perspective on family dynamics in coping with pain.     

Quality of Life and Adjustment in Youths with Asthma: The Contributions of Family Rituals and the Family Environment

This cross‐sectional study explored the relationships among family ritual meaning, cohesion, conflict, and health‐related quality of life (both specific to chronic health conditions and in general), and the emotional and behavioral problems reported by youths with asthma. Participants included 149 Portuguese children and adolescents between the ages of 8 and 18 who had been diagnosed with asthma and attended outpatient services at three public hospitals. The results showed that stronger family ritual meaning predicted a more positive family environment (i.e., higher cohesion levels and lower conflict levels), better health‐related quality of life, and fewer emotional and behavior problems in youths. Furthermore, family cohesion and conflict mediated the links between family ritual meaning and health‐related quality of life, and emotional and behavioral problems. These results did not change after controlling for participant age, gender, and asthma severity. The findings of this study suggest that family ritual meaning contributes to the adaptation of youths with asthma via its positive association with the family environment. The implications for multicontextual interventions with families are briefly discussed with regard to the positive role of family rituals and of their potential as a modifiable factor in families with increased health challenges.     

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.     

Changes in sleep quality and levels of psychological distress during the adaptation to university: The role of childhood adversity

Stress-related sleep disturbances are common, and poor sleep quality can negatively affect health. Previous work indicates that early-life adversity is associated with compromised sleep quality later in life, but it is unknown whether it predicts greater declines in sleep quality during stressful life transitions. We propose and test a conceptual model whereby individuals who reported experiencing greater levels of child maltreatment would experience greater psychological distress during a stressful life transition, which in turn would contribute to greater declines in sleep quality, relative to their quality of sleep before the stressful transition. Controlling for potential confounding variables (e.g., age, gender), structural equation modelling demonstrated that psychological distress experienced during a stressful transition (i.e., beginning life at university) mediated the relationship between childhood emotional neglect and changes in sleep quality. The hypothesized model demonstrated a good overall fit to the data, χ ² (15) = 17.69, p = .279, CFI = .99, TLI = .97, SRMR = .04, RMSEA = .04 (90% CI <0.001–0.09). Emotional neglect (β = .22) was positively associated with psychological distress which in turn was positively associated with poor sleep quality (β = .31) during a stressful transition. Future research should aim to understand the specific stressors in the university environment that are most challenging to individuals who faced early-life emotional maltreatment. These findings will help inform interventions to facilitate adaptation to a new environment and improve sleep quality for these university students.     

Integrated,Family‐based,Partial Hospital Treatment for Complex Pediatric Illness

This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD‐9 diagnoses. The multidisciplinary treatment team functions as a meta‐family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.     

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self‐report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off‐treatment). These findings reinforce the need for family‐ and parent‐based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.