Correlates of Regimen Adherence in Cystic Fibrosis

The present investigation studied psychological and familial factors associated with self-care adherence in a sample of 50 children (ages 9 to 17 years) with cystic fibrosis (CF). Children and their parents were recruited through an outpatient pediatric pulmonary medicine clinic at a metropolitan children's hospital. Participants were interviewed and administered measures of family behavior and child psychological variables. Regimen adherence was measured using a telephone interview approach across three occasions per participant. Hierarchical multiple regression with age, perceived family behaviors, health locus of control, and self-competency as predictors, accounted for 53.8% of the variance in regimen adherence. Findings suggest that higher self-esteem and younger age are related to higher rates of regimen adherence among children with CF.     

Perceived family environment as a moderator of young adolescents' life stress adjustment

A longitudinal design was employed to test the main and stress-moderating effects of young adolescents' perceived family environment (Family Environment Scales; FES; Moos & Moos, 1981) on their depression, anxiety, and self-esteem. This study was part of a larger longitudinal project (L. Cohen, Burt, & Bjorck, 1987) that demonstrated the significant cross-sectional effects of the young adolescents' controllable and uncontrollable negative events, and the significant longitudinal effects of the former. The present cross-sectional analyses demonstrated the hypothesized main effects of the FES scores; families perceived as cohesive, organized, and expressive were related to positive psychological functioning, whereas families perceived as conflict-ridden and controlling were related to negative functioning. However, in general these effects were nonsignificant in the longitudinal analyses. Although there were a number of significant Negative Events x FES interactions, in no instance did the pattern support the hypothesized stress-buffering role of positive family climate.     

Positive Psychological Functioning and the Biology of Health

Most research considers both psychological and physical health with a disease perspective by focusing on poor psychological functioning or disease outcomes. However, identifying attributes that support adaptive functioning may inform approaches to achieving health beyond what we learn from studying risk factors that accelerate deterioration. Recent evidence suggests that positive psychological functioning contributes to attaining optimal physical health. We evaluate the current state of knowledge on the relationship between positive psychological functioning and physical health, defining health beyond solely the absence of disease. We further consider when positive psychological functioning begins to exert effects on health, whether it has direct effects on biological processes or serves primarily to buffer the effects of stress, and whether it is associated with health outcomes and biological processes beyond those that reflect the absence of deterioration and disease. We propose some key directions for future research including the assessment of positive psychological functioning, positive biological functioning, and optimal health, the value of multi‐system measures, and the potential of “omics” to provide novel insights into biological mechanisms underlying associations between positive psychological functioning and physical health.     

Hospitalization of Children with Cystic Fibrosis Adversely Affects Mothers’ Physical Activity,Sleep Quality,and Psychological Status

Having a child with a chronic disease can cause anxiety and depression, which may impair the sleep quality of mothers. The aim of this study was to compare physical activity level, sleep quality, anxiety and depression in mothers of hospitalized cystic fibrosis patients, cystic fibrosis outpatients and healthy controls. Twenty-three of the patients were hospitalized and 38 were outpatients and 37 age-matched healthy children served as controls. The mothers’ fatigue levels, sleep disturbances, stress levels and perceptions of their child’s disease severity were assessed with a Visual Analog Scale. The International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale were administered to the mothers of children. Mothers of hospitalized and outpatient cystic fibrosis children had significantly higher fatigue severity, sleep disturbance, and stress level according to Visual Analog Scale than mothers of healthy controls. All of International Physical Activity Questionnaire scores were significantly lower in cystic fibrosis patients’ mothers than healthy controls’. Hospital Anxiety and Depression Scale depression score, Pittsburgh Sleep Quality Index subdomains and total scores of hospitalized patients’ mothers were higher than those of the other two groups (p?<?0.05). Chronic illness in children with cystic fibrosis may impair the physical activity level, sleep quality and psychological state of their mothers, especially during hospitalization period.     

Examining Relationships Between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family environments were related to adolescents’ psychological adjustment. Participants included 61 African American adolescents, ages 10–14 years old, and their parents. Hierarchical regression models were used to determine the cumulative effects of ethnic identity and family functioning on adolescent mental health, specifically adolescent levels of depression, self-esteem, and interpersonal functioning. Results indicated that having a positive ethnic identity and a cohesive family environment were most strongly associated with psychological adjustment. Implications of these results are discussed in terms of family interventions.     

Aerobic physical activity effects on psychological well-being in low-income Hispanic children

Psychological well-being has been generally associated with vigorous aerobic activity and structured aerobic activity in adolescents and children. Low-income children are at greater risk than the general population for experiencing high environmental stress and increased mental health problems. This study investigated the effects of a structured physical fitness program on psychological well-being in low-income Hispanic children. A total of 66, 33 girls, 33 boys, in Grade 4 were randomly assigned to either an Aerobic intensity (n = 34) or a Control intensity physical activity program (n = 32) for 6 wk. Psychological well-being was defined as scores on trait anxiety, depression, and self-esteem, measured, respectively, by the Trait Anxiety Inventory, Beck Depression Inventory, and Rosenberg Self-esteem scale. Analysis showed the children in the Aerobic intensity program significantly (p < .05) improved their cardiovascular fitness as measured by the PWC170 test. After the program was over, the children in this Aerobic group reported significantly (p < .05) less depression. The main effect for self-esteem reflected the Aerobic group's greater self-reported self-esteem. No differences were found on trait anxiety. The effects on depression and self-esteem may only be attributed to the cardiovascular improvement given the higher intensity physical activity program because causation was not assessed here.     

Economic Pressure and Children's Psychological Functioning

We examined the mediating role of family dynamics (marital quality, parental depression) in the link between economic pressure and child psychological functioning using the data from the National Survey of Family and Households (NSFH). From the initial multiethnic probability sample, we used a subsample of 2998 parents with a focal child 5 to 17 years of age. We used structural equation modeling using AMOS 4.0 to test the model. The results indicated support for associations among economic pressure, marital quality, parental depression, parenting strategies and children outcomes. Economic pressure was associated with lower marital quality and higher depression. Higher conflict and psychological distress was associated with frequent use of harsh discipline techniques and lower psychological functioning in children.     

Psychological adjustment of pediatric lung transplantation candidates and their parents

Investigated psychological functioning of 45 children and adolescents (ages 5 to 17 years) and their parents presenting at a major medical center for evaluation for lung transplantation. Patients completed self-reports, and parents completed measures on their children's behavior problems and emotional distress as well as on their own symptoms of distress. In general, children and their parents reported normal functioning on standard psychological measures. Few children fell in the clinically significant range, whereas 21% of mothers and 14% of fathers reported clinically significant levels of distress. Older children reported lower levels of depressive symptoms than younger children, and patients with cystic fibrosis manifested lower levels of internalizing symptoms than those with other pulmonary diseases. Findings demonstrate the resiliency of children and their parents facing a stressful point in the child's medical status and document the usefulness of psychological screening of patients and parents to identify those in need of clinical intervention.     

Family functioning in families of children with anxiety disorders.

The authors examined maternal and paternal reports of family functioning and their relationship with child outcomes as well as the association between anxiety and depression in family members and family functioning. Results reveal that maternal and paternal reports of family functioning were both significantly associated with worse child outcomes, including child anxiety disorder (AD) severity, anxiety symptoms, and child global functioning. Maternal and paternal anxiety and depression predicted worse family functioning, whereas child report of anxiety and depression did not. Parents of children with ADs reported significantly worse family functioning and behavior control, but only fathers reported worse problem solving and affective involvement compared with fathers of children with no psychological disorders. Findings from this study suggest that paternal as well as maternal anxiety and depression play a role in worse family functioning in children with ADs and that unhealthier family functioning is associated with worse child outcomes in this population.     

Association between morningness-eveningness and mental and physical health in adolescents

Individuals differ in their biological rhythms and their preference for morning or evening hours. Morning types prefer morning hours for intellectual and physical activities while evening types feel and perform best at late afternoon or in the evening. This not only is a simple dichotomous classification but also can be viewed as a continuum. Individual differences in morningness-eveningness are an interesting facet of personality, but little is known about the relationship between psychological factors or health-related variables and morningness-eveningness in adolescents. In Study I, there were positive correlations between morningness and positive attitude towards life and a negative association between morningness and depression. In Study II, there were significant positive relationships between morningness and physical health, mental health, self-esteem, familial relationship, and school functioning. These results indicate that eveningness might be an unspecific risk factor for mental and physical health.     

班级结构对留守儿童心理健康的影响:同化还是对比效应?

基于河南和陕西两省17所农村学校4~9年级103个班级内4021名学生的调查数据,分析了班级结构(一般农村儿童在班级中所占比例)对不同家庭背景儿童心理健康的影响机制.采用学校固定效应模型控制校际间差异后发现:(1)对于自尊和未来压力感知,班级结构存在对比效应,即班级内一般农村儿童比例越高,留守儿童的自尊水平越低,特殊结构家庭的儿童会感知到的未来压力更大,但对一般农村家庭儿童的影响不显著;(2)对于抑郁症状,班级结构则存在同化效应,即所在班级内其他学生的平均抑郁水平对个体自身的抑郁症状有显著的预测作用.     

Self-Esteem and Its Relationship to Mental Health and Quality of Life in Adults with Cystic Fibrosis

Research from the general population indicates an important role for self-esteem in mental health, but limited research in this area exists in the cystic fibrosis (CF) literature. This study aimed to explore the predictive value of self-esteem and health-related quality of life (HRQoL) in mental health symptoms in adults with CF. Seventy-four participants, recruited online, completed the Clinical Outcomes in Routine Evaluation-Outcome Measure 34 (CORE-OM), Rosenberg Self-esteem Scale and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Comparably high levels of self-esteem were found, but HRQoL was lower than previous research. Thirty percent of participants scored within the clinical range for mental health difficulty. Hierarchical regression, controlling for gender, explored the value of four CFQ-R subscales (physical, social, emotional and role functioning) and self-esteem in predicting CORE-OM total score. Gender accounted for 8.2 % of the variance in mental health scores while the five independent variables accounted for a further 73.0 % of variance. Of the five variables, CFQ-R emotional functioning and self-esteem were significant predictors of mental health symptoms. Results are discussed in relation to clinical implications and potential uses for internet technologies to promote socialisation.     

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.     

The Family Environment in Chronic Pain Patients: Comparison to Controls and Relationship to Patient Functioning

Operant and cognitive-behavioral models of chronic pain have called attention to the importance of examining the marital and family environments of chronic pain patients. In this study, 50 chronic pain patients and their spouses and 33 control participants and their spouses completed measures of the family environment, marital satisfaction, and patient physical and psychological functioning. Patients' overt pain behaviors were coded from videotapes of patient–spouse interactions. Compared to controls, pain patients and their spouses rated their family environments as lower in cohesion and higher in control, and there was a trend for spouses to report more marital dissatisfaction. Chronic pain patient depression was associated negatively with patient-rated family cohesion and expressiveness and spouse-rated family organization and positively with patient-rated family conflict. Overt patient pain behaviors and spouse-rated patient disability were related negatively to spouse-rated family cohesion. Spouse marital satisfaction was associated negatively with patient depression and with spouse ratings of patient disability and pain behaviors.     

The mediating and moderating effects of differentiation of self on body mass index and depressive symptomatology among an American college sample

Differentiation of self – a core construct of Bowen's (Bowen, M. (1978). Family therapy in clinical practice. New York: Jason Aronson) family systems theory – was examined as a possible predictor of psychological health and physical health and as a mediator and moderator of the relation between overall functioning and psychological health and physical health. A total of 818 American college students participated (mean age?=?23.72, SD?=?4.79) in this study. Differentiation of self was correlated and was predictive of psychological health, as measured by the Beck depression inventory, and physical health, as measured by body mass index (BMI). A multivariate multiple regression model revealed that differentiation of self partially mediated the effects of overall functioning on depressive symptomatology and on BMI. Results from a hierarchical regression model showed that differentiation of self moderated the relation between overall functioning and depressive symptomatology but did not moderate the relation between overall functioning and BMI. Taken together, these preliminary findings provide initial evidence of the importance of the associations between family systemic factors (differentiation of self) and psychological and physical health factors among American college populations.     

单亲家庭儿童相对剥夺感与心理适应的循环作用关系：一项追踪研究

本研究基于经典相对剥夺理论和发展情境理论, 采用纵向设计, 以湖北省某地区273名单亲家庭儿童为被试, 进行连续3次的追踪测查, 考察单亲家庭儿童相对剥夺感与心理适应的特点及其循环作用关系。结果发现: (1)单亲家庭男生的抑郁和孤独感水平比女生高; 贫困单亲家庭儿童的相对剥夺感、抑郁和孤独感水平比非贫困单亲家庭儿童高, 自尊水平比非贫困单亲家庭儿童低; (2)控制了性别、学段和家庭经济状况后, 在个体内水平上T1时的相对剥夺感显著负向预测T2时的心理适应, 进而显著负向预测T3时的相对剥夺感, 同时T2时的相对剥夺感也能显著负向预测T3时的心理适应; (3)相对剥夺感与心理适应的循环作用在不同家庭经济状况单亲儿童中存在显著差异, 贫困单亲家庭儿童的心理适应对其相对剥夺感的作用比非贫困单亲家庭儿童更大。可见, 单亲家庭儿童的相对剥夺感与心理适应存在循环作用关系, 即前测(T_n)的相对剥夺感会导致后测(T_n+1)的心理适应不良, 进而影响后测(T_n+2)的相对剥夺感, 研究结果对于单亲家庭儿童心理适应的干预具有一定启示意义。     

Family Functioning,Parental Psychological Distress and Child Behaviours: Evidence from the Victorian Child Health and Wellbeing Study

We examined, using data from the 2006 Victorian Child Health and Wellbeing Study (VCHWS), whether family functioning is associated with parental psychological distress and children's behavioural difficulties. The VCHWS was a statewide cross‐sectional telephone survey to 5,000 randomly selected primary caregivers of 0‐ to 12‐year‐old children between October 2005 and March 2006. Only parents or guardians of children aged 4–12 years (n = 3,370) were included in this study. After adjusting for sociodemographic variables and ethnicity, parents or guardians scoring higher on the family functioning scale (i.e., from poorly functioning households) were at greater risk of psychological distress and had children with lower levels of prosocial behaviour and higher levels of behavioural difficulties relative to those from healthily functioning households. Mental health prevention programmes addressing child mental and conduct problems should consider the family environment and target those families functioning poorly.     

Family and childhood adjustment in cystic fibrosis

Family adaptation has been commonly associated with the psychological adjustment of chronically ill children. However, few studies have attempted to systematically evaluate this association and its relationship to illness severity. We studied 44 children ages 7 to 15 and their families at a large cystic fibrosis center and obtained measures of 1) impact of illness on the family; 2) family functioning; 3) behavioral adjustment; 4) social competence; 5) ratings of anxiety, depressive, and eating disorder symptoms; and 6) ratings of illness severity and duration. Impact of illness on the family and overall family dysfunction were significantly correlated with illness severity, but not duration. However, impact of illness on the family was significantly correlated with internalizing behavioral symptoms, while family dysfunction was correlated with depressive symptomatology. These findings suggest that illness-related stress is primarily reflected in general emotional and behavioral symptoms, with familial adaptation either ameliorating or exacerbating their development into depressive symptomatology.     

Social control, health risk taking, and psychological distress among the elderly

Most research on older adults' social networks has focused on the support-providing function of social relationships. Little gerontological research has addressed social control, or the role of social bonds in regulating deviant or risky behavior. Drawing on sociological theory, this study examined the hypothesis that social control discourages risky health practices while provoking psychological distress. Structured interviews conducted with 162 community-residing older adults assessed social control (direct attempts by other to influence participants' health practices and the existence of significant role obligations to others), health risk taking (medication misuse, alcohol consumption, cigarette smoking, and the overall level of unsound health practices), psychological functioning (depression, loneliness, and self-esteem), and interpersonal satisfaction (satisfaction with friends and family members). Analyses revealed little support for the hypothesis. Social control was only weakly related to participants' health practices and, contrary to expectation, was generally related to less psychological distress and to greater interpersonal satisfaction. Implications for social control theory and for further research are addressed.     

A Mixed-method Study of Individual,Couple, and Parental Functioning During the State-regulated COVID-19 Lockdown in Spain

During the recent COVID-19 outbreak in Spain, we explored the individual and relational well-being of people confined together with their partners and/or children during the first 3 weeks of state-regulated lockdown. Adults 18 years or older (N = 407) completed an online survey that included demographic, household, and employment information along with standardized measures of psychological distress (State-Trait Anxiety and Beck Depression) and relationship functioning—either the Dyadic Adjustment Scale if there were no children in the household or a Basic Family Relations Evaluation Questionnaire (CERFB) measuring conjugal, parental, and coparental functions. Qualitative analyses of responses to an open-ended question about perceived changes in couple or family dynamics during lockdown revealed nine specific themes comprising two overarching categories: relational improvement and deterioration. The overall prevalence of improvement themes (61.7%) exceeded deterioration themes (41.0%), with increased (re)connection and conflict atmosphere cited most often. Quantitative analyses found elevated levels of state anxiety but not trait anxiety or depression during lockdown. Consistent with the qualitative results, couples having no children at home reported high levels of dyadic adjustment, but with children present CERFB parental functioning exceeded conjugal functioning, a pattern sometimes associated with child triangulation into adult conflicts. Although correlates of psychological distress (e.g., unemployment, perceived economic risk) were relatively stable across subgroups, predictors of relationship functioning varied substantially with household/parental status (e.g., telecommuting and employment facilitated conjugal functioning only for couples with children).