Cultural issues in disease management for chinese americans with type 2 diabetes

The purpose of this study is to highlight culturally unique experiences and responses to type 2 diabetes among Chinese immigrant families. Patient and spouse narratives from 16 different families were elicited in a series of group interviews on this topic. Using interpretive phenomenology, 5 primary cultural considerations in diabetes management emerged from the narratives: (1) conceptualization of diabetes, illness and health, (2) significance and meaning of food, (3) perceptions of Chinese and Western medicines, (4) exercise and physical activity, and (5) effects of the disease on family dynamics. The relation of these cultural considerations to an interdependent view of the self, collectivistic social orientation, Chinese cultural beliefs and norms, and acculturation processes are discussed. Clinical recommendations for culturally appropriate disease management strategies are outlined.     

The child abusing family: I. Methodological issues and parent-related characteristics of abusing families

Abstract

The physical abuse of children by their parents is a family matter and should be viewed within the context of the family unit. Unfortunately, few child abuse studies have directly examined the family unit. Rather, most studies focus on characteristics of individual members of abusing families or on dyadic relationships within abusing families. Therefore, the present paper examines the family-related variables that might contribute to child abuse. This review is divided into two parts. Part I discusses methodological considerations and parent-related aspects of abusing families, including: characteristics of abusing parents, childhood experiences of abusing parents, marital relationships of abusing parents and the perceptions and expectations that abusing parents have of their abused children. Part II of this review, which will appear in a later issue, will cover child-related aspects of abusing families, parent-child interactions in these families, environmental conditions associated with child abuse and typologies of abusing families.     

Family Cultures in The Context of Migration and Ageing

Intergenerational family relations are embedded in family cultures which influence how families regulate their relations over the whole life span with regard to key issues, such as autonomy and relatedness, or support exchange and reciprocity, and which may vary inter- and intraculturally. Migrant families undoubtedly face a special situation as values and expectations from the culture of origin and from the host cultural context might differ. Not much is known yet about how migrant families adapt their family cultures to the host cultural context. The present article will focus on aspects of intergenerational family regulation by taking into account family cultures of migrant compared to non-migrant families in a life span perspective. We will illustrate our theoretical outline by presenting first results from the IRMA-study comparing Luxembourgish and Portuguese immigrant families living in Luxembourg. We focus on issues of family cohesion, enmeshment and normative expectations regarding adult children’s support for their ageing parents, by drawing both on quantitative questionnaire as well as qualitative interview data. Implications for the experience of ambivalence and conflicts as well as well-being of family members from both generations will be discussed.     

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers’ mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths’ attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9–16 years to explore their perspectives on maternal depression. All youth had participated in a 12‐week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture‐specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.     

Attachment theory and systemic practice: research update

Attachment theory offers a way of thinking about the dyadic relationships within the family system. Family systems theory and therapy can contribute to attachment theory, as dyadic relationships do not exist in isolation but within the context of other relationships. Research at the interface between systemic practice and attachment theory is reviewed with examination of the central role they may play together in the developing understanding of family relationships.     

Attachment within family systems: An overview

A family systems approach provides a context for the development and maintenance of dyadic attachment relationships. An attachment approach provides a focus on the expression of and response to attachment behavior within a family. Uniting the two approaches has implications for both research and intervention. Characteristics of attachment theory and family systems theory are briefly outlined: Both involve systemic thinking. Different styles of interacting at the level of the family as a whole, working models of relationships, and dyadic interactions appear to correspond in a coherent way. Further research is needed in order to identify which dimensions of family functioning are relevant to the development of secure attachments, and how the relevant dimensions may change with age and stage in the family life cycle. This will provide targets for preventive interventions, with the development of secure relationships as a primary goal.     

Family work for schizophrenia: some issues for Chinese immigrant families

This paper discusses some specific issues relevant to immigrant Chinese families in the context of family work for schizophrenia. The issues include shame and guilt, isolation and mistrust of officials, the importance of negotiation before details of problem-solving are worked out, high academic ambitions for children, and apparent ‘overprotectiveness’ in the Chinese culture. It is argued that cognitive-behavioural, goal-orientated family work could be adapted well for immigrant Chinese families with a member suffering from schizophrenia. A case study is presented to illustrate how such a family was helped.     

Attachment and well-being: The mediating effects of psychological needs satisfaction within the coach–athlete and parent–athlete relational contexts

ObjectivesGrounded in attachment theory and self-determination theory, this study aimed to examine whether basic needs satisfaction is a mechanism by which athletes' insecure attachment styles are associated with levels of well-being.MethodAthletes (N = 430) from a range of sports and competition levels completed a multi-section questionnaire to assess the main variables of the study.ResultsBootstrap mediation analysis revealed that athletes' perceptions of satisfaction of basic psychological needs generally mediated the association between their attachment styles and well-being. Moreover, the indirect effect of athletes' experience of the satisfaction of basic needs on well-being was greater within the parental relational context than within the coaching relational context.ConclusionsOverall, the findings from the study highlight that the integration of attachment and self-determination theories can promote understanding of relational process in sport.     

An Ecological Understanding of Kinship Foster Care in the United States

We review empirical studies on kinship foster care in the United States. We conceptualize kinship foster care within the context of Urie Bronfenbrenner’s (1994) most recent ecological systems theory. Because there are multiple levels of influences on the developmental outcomes of children placed in kinship foster home, understanding the interrelations between the individual (child) and his or her surrounding environments (e.g., biological families, social-support network) is important. We argue that Bronfenbrenner’s most recent ecological systems theory is an appropriate theoretical framework for policy and practice implications in addressing complex issues surrounding kinship foster care system in the United States. This review integrates the empirical findings collectively on the factors associated with kinship foster care within and between five systems levels of the ecological systems theory: micro- (caregiver-child relationship, attachment, and kinship family environment), meso- (biological families), exo- (social-support network outside the family), macro- (race/ethnicity and policies), and chrono- (welfare reform) systems levels. Theories that are relevant to the ecological factors (e.g., attachment theory) are also discussed. Finally, we draw policy and practice implications from the ecological systems analysis.     

The Family Cycle: An Activity to Enhance Parents’ Mentalization in Children’s Mental Health Treatment

This article introduces the Family Cycle, a therapeutic activity informed by attachment theory, family systems theory, and current literature on reflective functioning. The Family Cycle helps clinicians and families create a narrative about a child’s psychopathology that considers complex trauma and/or adverse childhood experiences. It reframes observable dysfunctional phenomena as behavioral sequelae of more deeply rooted emotional loss. After the theoretical underpinnings of the Family Cycle are laid out, we describe the implementation of the Family Cycle within the context of an intensive home-based, family-focused intervention created at the Yale Child Study Center, the Intensive In-Home Child and Adolescent Psychiatric Service (IICAPS). The Family Cycle provides a teachable clinical framework to facilitate the treatment of families with complex, multigenerational trauma.     

Afterword: new directions in research with immigrant families and their children

Although migration is fundamentally a family affair, the family, as a unit of analysis, has been understudied both by scholars of migration and by developmental psychologists. Researchers have often struggled to conceptualize immigrant children, adolescents, and their families, all too often giving way to pathologizing them, ignoring generational and ethnic distinctions among immigrant groups, stereotyping immigrants as "problem" or (conversely) "model" minorities, and overlooking the complexity of race, gender, documentation, and language in their lives. In addition, contexts other than the family remain understudied. In this afterword, the authors examine these issues, the contributions of the chapters in this volume to understanding them, and their implications for research and theory within the field of developmental science.     

Reconstructing the Brothers Grimm: new tales for step-family life

Step-families are situated within the sociopolitical context of family change and are examined as a prototype of the "post-modern" family. This essay looks at the cultural construction of step-family life and proposes a model for collaboratively reconstructing stories that liberate step-relationships from the legacy of the Brothers Grimm, deconstructing the stories of failure, insufficiency, and neglect. Building on narrative and social constructionist ways of thinking about families, the concept of side-shadowing (a hermeneutic approach from literary/historical criticism) is introduced to elucidate how therapists can help family members discover ways of thinking, feeling, and behaving that are both more personally satisfying and more congruent with the changed context of family life. Two therapeutic challenges are high-lighted: reconceptualizing what it means to be a step-family and coming to terms with differential attachment in relationships while working with step-families. The essay ends with a fairy tale for the 21st century.     

Inheritance of Religiosity Among Muslim Immigrants in a Secular Society

This study examined the intergenerational transmission of religiosity within Muslim immigrant families who live in the Netherlands, a rather secular society. We studied whether transmission of religiosity within immigrant families is influenced by warm family relations on the one hand, and integration into the host country on the other hand. Two analyses were carried out on a nationally representative sample of Turkish and Moroccan first- and second-generation immigrants aged 15–45, in the Netherlands. The findings support the hypotheses to some extent: warm family ties are found to facilitate religious transmission but transmission is stronger when parents have different national backgrounds. A stronger transmission is found within families that are stronger embedded in religious communities; however there are large differences between men and women. Our research shows that the influence of parental religiosity cannot be ignored in the study of immigrants’ religiosity.     

A Community‐Responsive Adaptation to Reach and Engage Latino Families Affected by Maternal Depression

As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community. We describe a cultural adaptation framework that is responsive to the unique opportunities and challenges of identifying and recruiting vulnerable families through community partnerships, and of addressing the needs of families by incorporating multiple community perspectives. Specifically, we apply these principles to the cultural adaptation of an intervention originally developed for low‐income African American and White families facing maternal depression. The new intervention, Fortalezas Familiares (Family Strengths), was targeted to Latino immigrant families whose mothers were in treatment for depression in mental health and primary care clinics. We conclude with key recommendations and directions for how family researchers and practitioners can design the cultural adaptation of interventions to be responsive to the practices, preferences, and needs of underserved communities, including families and service providers.     

Adolescents in conflict: Intercultural contact attitudes of immigrant mothers and adolescents as predictors of family conflicts

Recent research demonstrates that intergenerational differences in immigrant families' adaptation can be detrimental for family functioning. However, most of the findings originate from immigrant groups in North America who face different situations compared with European Diaspora returnees. This comparative study investigated whether ethnic German Diaspora immigrant adolescents' and mothers' disagreement about the desirability of adolescents' intercultural contact with native peers relates to more conflict in the family domain. In addition, we accounted for general developmental factors predicting family conflict by considering adolescents' background in terms of prosocial behaviour and hyperactivity. Participants comprised 185 Diaspora immigrant mother–adolescent dyads from the former Soviet Union living in Germany (adolescents: mean age 15.7 years, 60% female) and 197 native German mother–adolescent dyads (adolescents: mean age 14.7 years, 53% female). Results indicated a similar level of family conflict in immigrant and native families. However, conflict was elevated in those immigrant families disagreeing on intercultural contact attitudes, independent of the significant effects of adolescents' background of prosocial behaviour or hyperactivity. Our study highlights potential side effects in the family domain, if immigrant adolescents and parents disagree in their attitude regarding adaptation to the host culture's life domains, such as contact with native peers.     

Mentalizing Family Violence Part 1: Conceptual Framework

This is the first of two companion papers describing concepts and techniques of a mentalization‐based approach to understanding and managing family violence. We review evidence that attachment difficulties, sudden high levels of arousal, and poor affect control contribute to a loss of mentalizing capacity, which, in turn, undermines social learning and can favor the transgenerational transmission of violent interaction patterns. It is suggested that physically violent acts are only possible if mentalizing is temporarily inhibited or decoupled. However, being mentalized in the context of attachment relationships in the family generates epistemic trust within the family unit and reduces the likelihood of family violence. The implications of this framework for therapeutic work with families are discussed.     

Parent–Child Conflict Profiles in Chinese American Immigrant Families: Links to Sociocultural Factors and School‐Age Children's Psychological Adjustment

Research suggests that parent–child conflict is a salient family process in Asian immigrant families and often a stressful experience for Asian American youth due to value discrepancies between Asian and Western cultures. The present study examined ratings of parent–child conflict across conflict topics from parents' and children's perspectives in a sample of Chinese American immigrant families with school‐age children (N = 239; age = 7.5–11 years). Latent profile analyses identified three parent‐rated conflict profiles and four child‐rated conflict profiles. Parent and child conflict profiles were unrelated to each other and differentially related to family sociocultural factors and children's psychological adjustment. Parents' moderate conflict profile scored highest on parent‐rated child behavior problems and had the highest household density and lower parent Chinese orientation. Children's moderate‐specific and high conflict profiles scored higher on child‐reported behavior problems than the low conflict profile. These results highlight the need to assess family conflict from both parents' and children's perspectives and target parent–child conflict communication as a pathway to prevent or reduce behavioral problems in Chinese American children of immigrant families.