Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors.

Childhood cancer patients have a greater likelihood of long-term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment.     

Parent–Teen Interactions as Predictors of Depressive Symptoms in Adolescents with Headache

This study investigated parent–adolescent conflict, family functioning, and adolescent autonomy as predictors of depressive symptoms in adolescents with primary headache. Frequent headaches during adolescence can have a negative impact on activity levels and psychological functioning. Depression is particularly prevalent in adolescents with headache but little research has examined the role of parent–teen interactions in predicting depressive symptoms. Thirty adolescents diagnosed with migraine or chronic daily headache completed self-report measures of pain intensity, parent–adolescent conflict, family functioning, and depression. Adolescents and their parents also participated in three videotaped interaction tasks, scored by independent raters to assess adolescent autonomy. Regression models revealed that pain intensity, parent–adolescent conflict, and autonomy predicted depressive symptoms. Higher levels of conflict, poorer family functioning and lower levels of autonomy were associated with more depressive symptoms. This study highlights the association between parent–teen interactions and psychological functioning in adolescents with primary headache. Implications for intervention are discussed.     

Coping with Family Conflict: What’s Helpful and What’s Not for Low-income Adolescents

Family conflict is exacerbated by poverty-related stress and is detrimental to adolescent mental health. Adolescent coping with family conflict has the potential to buffer or exacerbate the negative effects of family conflict on internalizing symptoms. We examined coping with family conflict among 82 low-income adolescents (53.7% female, mean age = 13.5 years at Time 1, SD = 1.98; range 11–18), and their primary caregivers (95% female, mean age = 34.9 years, SD = 7.45). Adolescents were 25.9% Caucasian, 28.4% African American, 38.3% Hispanic, and 7.4% Other (Multi-racial, Native American, or Asian). Results show that family conflict is more strongly associated with internalizing symptoms for adolescents under high levels of poverty-related stress. Regression analyses indicate that secondary control coping moderates the effects of family conflict on internalizing symptoms. In addition, analyses reveal that disengagement coping exacerbates symptoms across time for both adolescent girls and boys. Regression analyses also suggest that primary control coping is helpful for coping with family conflict, but only for girls. Results highlight the importance of examining coping concurrently and across time as well as including moderating effects of gender. Intervention efforts targeting low-income adolescents should incorporate the instruction of secondary control strategies for coping with family conflict.     

Factors associated with the mental health of adolescents when a parent has cancer

This study explored factors associated with the mental health in adolescents (ages 11-17; n = 54) within 12 months after a parent had been diagnosed with cancer. A control group was included (ages 11-17; n = 49). A demographic questionnaire, the SF-8 Health Survey, the Youth Self Report and the McMaster Family Assessment Device were used. Similar levels of psychological distress and healthy family functioning were reported in the clinical and the control group. No effect of gender of the ill parent and that of the adolescent was found. A negative correlation was found between the physical health of the ill parent and the mental health of the adolescent. Healthy family functioning correlated with less psychological distress in adolescents with a parent with cancer. Open communication, flexible problem solving and appropriate affective involvement were significant predictors for less psychological distress in the adolescents. The study concludes that a healthy family functioning facilitated the adolescent's adjustment to parental cancer.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Implications of Family Cohesion and Conflict for Adolescent Mood and Well-Being: Examining Within- and Between-Family Processes on a Daily Timescale

Family-level conflict and cohesion are well-established predictors of adolescent mental health. However, traditional approaches focusing on between-family differences in cohesion and conflict may overlook daily intrafamily variability that might provide important new information. We used data from a 21-day daily diary protocol in a sample of 151 caregivers (95.3% female) and their adolescent child (61.5% female) in two-caregiver families to test whether daily changes in family functioning are associated with daily changes in adolescent well-being and whether adolescent well-being depends on average levels of family functioning. We examined family cohesion and conflict in relation to adolescent angry, depressed, and anxious mood, as well as happiness, life satisfaction, and meaning and purpose in life in multilevel models. Both cohesion and conflict exhibited meaningful daily variation. Adolescent-reported cohesion and conflict had unique within-family associations with all six adolescent outcomes. Models using parent reports of family functioning yielded fewer associations than models with adolescent reports; however, several findings remained. Cross-level interactions indicated that within-family variations in cohesion were only associated with adolescent depression in families with lower average levels of cohesion across days. In sum, this study provides compelling evidence that families exhibit meaningful variability from day to day and that daily variation has important implications for adolescent well-being.     

Predictors of Psychosocial and Cognitive Adaptation in Children with Sickle Cell Syndromes

Examined the role of socioecological factors (family functioning and socioeconomic variables) in predicting behavioral and cognitive adaptation in children with sickle cell syndromes (SCD). Participants included 74 African American children and adolescents with SCD and their primary caretakers. Outcomes included internalizing and externalizing behavior symptoms, as rated by caretakers, as well as intellectual abilities and academic achievement, as assessed by individually administered standardized instruments. Family functioning consisted of both caretaker adjustment and family environment (i.e., family adaptability and cohesion). Hierarchical multiple regression analyses revealed that caretaker psychological adjustment predicted externalizing behaviors, while family environment (i.e., adaptability and cohesion) predicted neither behavioral nor cognitive functioning. Socioeconomic variables alone predicted intellectual abilities and academic achievement and also contributed to the prediction of child behavioral adaptation. Results are discussed in terms of relevant sociocultural issues and implications for family-level prevention and intervention.     

Operating within the mainstream: Coping and adjustment among a sample of homosexual youths

A sample (N = 37) of African American adolescent homosexual males was administered a questionnaire that focused on four areas of social psychological functioning (self‐identity, family relation, school‐work relations, and social adjustment). The findings contradicted several past studies that reported in general that homosexual males experience crippling cognitive dissonance. Even with the existence of homophobia in the society, the adolescents were found to possess an adequate social psychological attitude and survival skills. The sampled adolescents reported being comfortable with their sexual orientation even though the majority of them had not disclosed their homosexuality. The respondents reported how they managed self‐presentation among heterosexual persons. The adolescents appeared well‐adjusted and stable in their social functioning and disagreed with the idea that they needed professional counseling.     

Author Index

The association between family functioning and adolescent adjustment was examined in 429 Chinese adolescents via children's and parents' reports. The ratings obtained from the different sources indicated that family functioning was significantly related to measures of (a) adolescent psychological well-being (general psychiatric morbidity, life satisfaction, purpose in life, hopelessness, and self-esteem), (b) school adjustment (perceived academic performance and school conduct), and (c) problem behavior (smoking and abusing psychotropic drugs). The findings suggest that there is an intimate link between family functioning and the psychosocial adjustment, particularly the positive mental health, of Chinese adolescents.     

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.     

Online racial discrimination and the protective function of ethnic identity and self-esteem for African American adolescents

A growing body of literature has shown that being victimized online is associated with poor mental health. Little is known about the factors that protect youth from the negative outcomes that may result from these victimization experiences, particularly those related to race. Using a risk and resilience framework, this study examined the protective function of ethnic identity and self-esteem among African Americans who experience online racial discrimination. For the sample of 125 adolescents, hierarchical regression results revealed that higher levels of ethnic identity and self-esteem significantly moderated the negative impact of online racial discrimination on anxiety levels. These findings show that ethnic identity and self-esteem can buffer the negative mental health outcomes associated with online racial discrimination, at least with respect to adolescents' anxiety. Findings from the current study have significant implications for adolescent adjustment given the increased time youth spend doing online activities.     

The influence of ethnic discrimination and ethnic identification on African American adolescents' school and socioemotional adjustment

Abstract Do experiences with racial discrimination at school predict changes in African American adolescents' academic and psy‐chological functioning? Does African American ethnic identity buffer these relations? This paper addresses these two questions using two waves of data from a longitudinal study of an economically diverse sample of African American adolescents living in and near a major East Coast metropolis. The data were collected at the beginning of the 7th grade and after the completion of the 8th grade. As expected, experiences of racial discrimination at school from one's teachers and peers predicts declines in grades, academic ability self‐concepts, academic task values, mental health (increases in depression and anger, decreases in self‐esteem and psychological resiliency), and increases in the proportion of one's friends who are not interested in school and who have problem behaviors. A strong, positive connection to one's ethnic group (our measure of ethnic identity) reduced the magnitude of the association of racial discrimination experiences with declines in academic self‐concepts, school achievement, and perception of friends' positive characteristics, as well as the association of the racial discrimination experiences with increases in problem behaviors.     

Familial Influences on Dating Violence Victimization Among Latino Youth

Despite theoretical and empirical evidence suggesting that the family environment plays a central role in Latino youth development, relatively little is known about how family processes influence dating violence victimization among Latino adolescents. To address this gap in the literature, we used data from 210 Latino parents and their 13- to 15-year-old adolescents to examine associations between several different family processes, including both parenting practices (parent monitoring, parent–adolescent communication) and aspects of the family relational climate (family cohesion, family conflict, acculturation conflict) and psychological, physical, and sexual dating violence victimization. Consistent with expectations, lower levels of family cohesion and higher levels of family and acculturation conflict were associated with risk for dating violence victimization, although associations varied depending on victimization type. In contrast, neither parental monitoring nor parent–adolescent communication was significantly associated with any type of dating violence victimization. In addition, we found that parent, but not teen, Anglo-American acculturation was associated with higher dating violence victimization risk. Findings suggest that family-based dating abuse prevention programs for Latino youth should seek to increase family cohesion and decrease family conflict, including acculturation-based conflict.     

Associations of Parent-Adolescent Discrepancies in Family Cohesion and Conflict with Adolescent Impairment

Family cohesion and family conflict are important protective and risk factors respectively in the development of child psychopathology. Our study examines parent-adolescent discrepancy of the family environment constructs, family cohesion and family conflict, and their associations with adolescent impairment. The sample consists of 141 parent-adolescent dyads evaluated at an outpatient behavioral health clinic. The mean adolescent age is 14.8 (range 11–18) while the mean parent age is 48.9 (range 32–67). Findings show that adolescents report significantly less family cohesion but do not differ significantly in reports of family conflict. Greater family cohesion is associated with less adolescent impairment by multiple reporters. Nonetheless, greater family conflict is associated with more adolescent impairment by the same reporter. The results show that both adolescent and parent reports of family cohesion and conflict are important to consider when integrating information gathered in a clinical assessment.     

Family Functioning and Psychological Well-Being,School Adjustment,and Problem Behavior in Chinese Adolescents With and Without Economic Disadvantage

Using an indigenously developed measure of family functioning, the author examined the association between family functioning and adolescent adjustment in 1,519 Chinese adolescents. Results showed that family functioning was significantly related to measures of adolescent psychological well-being (existential well-being, life satisfaction, self-esteem, sense of mastery, general psychiatric morbidity), school adjustment (perceived academic performance, satisfaction with academic performance, and school conduct), and problem behavior (delinquent and substance abuse behavior). Family functioning was generally more strongly related to measures of adolescent adjustment for adolescents with economic disadvantage than for adolescents without economic disadvantage.     

Differences in family functioning in grandparent and parent-headed households in a clinical sample of drug-using African American adolescents

Grandparents play a critical role in African American families, providing support and important leadership functions. Little is known, however, about family functioning in grandparent-headed households with a drug-using adolescent. Such knowledge is particularly salient for researchers and therapists who work with drug-using adolescents and their families. Using a clinical sample of convenience, analyses were conducted to identify similarities and differences in adolescent substance use and behavior problems, family relationships, and family social ecology relationships between African American grandparent-headed (n=12) and parent-headed (n=54) households. Results indicated that adolescents from the 2 household types reported similar levels of problem behaviors, but that grandparents reported less delinquency with peers than did parents. Primary caregivers in grandparent-headed households reported less monitoring and supervision of peers and less within-family conflict. Implications for treatment are discussed.     

Family functioning and psychological well-being,school adjustment,and problem behavior in chinese adolescents with and without economic disadvantage

Using an indigenously developed measure of family functioning, the author examined the association between family functioning and adolescent adjustment in 1,519 Chinese adolescents. Results showed that family functioning was significantly related to measures of adolescent psychological well-being (existential well-being, life satisfaction, self-esteem, sense of mastery, general psychiatric morbidity), school adjustment (perceived academic performance, satisfaction with academic performance, and school conduct), and problem behavior (delinquent and substance abuse behavior). Family functioning was generally more strongly related to measures of adolescent adjustment for adolescents with economic disadvantage than for adolescents without economic disadvantage.     

Family Environment in Inner-City African-American and Latino Parents/Caregivers: A Comparison of the Reliability of Instruments

Inner-city, African American and Latino youth are at higher risk for the development of obesity and type 2 diabetes. Interventions usually focus on changing physical activity and dietary behaviors, yet family environment has the potential to influence response to these interventions. We aimed to identify instruments that could reliably be used to assess the family environment of children from high-risk populations. Selected indices from four instruments were used; the Family Environment Scale (FES), the Family Adaptability and Cohesion Evaluation Scales IV (FACES IV), the Self-report Family Inventory (SFI), and the Family Assessment Device (FAD). Out of 15 indices evaluated, 9 were reliable in both ethnicities including FES cohesion, conflict and organization, SFI emotional expressiveness, conflict and family health/competence, FACES IV family communication and family satisfaction, and FAD general functioning. Perceived family environment characteristics did not differ significantly for inner-city African American and Hispanic families.     

Unfolding Relations among Mindful Parenting,Recurrent Conflict,and Adolescents’ Externalizing and Internalizing Problems

The current study examined unfolding relations among mothers’ mindful parenting, parent–adolescent recurrent conflict, and adolescents’ externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2–3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent–adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.     

Ethnic identity,thin-ideal internalization,and eating pathology in ethnically diverse college women

Although much research suggests that ethnic identity is positively correlated with psychological health for ethnic minority women, research examining ethnic identity's relationships to thin-ideal internalization, weight concerns, and eating concerns is sparse. Consequently, this study examined these relationships in European American, African American, Latina, and Asian American college women (N = 816). As expected, univariate analyses of variance indicated that European American women scored lowest on ethnic identity and highest on eating and weight concerns, whereas African American women scored lowest on thin-ideal internalization. Hierarchical regression analyses indicated that ethnic identity was negatively associated with eating and weight concerns, while body mass index and thin-ideal internalization were positively associated. Ethnic identity moderated the relationship between thin-ideal internalization and eating concerns such that the relationship was stronger for participants with lower ethnic identity. These results suggest ethnic identity may be a direct or interactive protective factor against eating concerns in ethnically diverse college women.