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.     

Values and psychological well-being among adolescents – are some values ‘healthier’ than others?

We analyzed links between psychological well-being (PWB: autonomy, environmental mastery, personal growth, relationships, purpose, self-acceptance) and values among 147 adolescents. Values corresponded with PWB: Openness to change correlated positively with Autonomy and negatively with Purpose in Life; Self-enhancement negatively with Environmental Mastery, Personal Growth and Positive Relationships; Self-transcendence positively with Personal Growth and Positive Relationships; Conservation negatively with Autonomy, but positively with Purpose in Life. We identified four value clusters: ‘Young wolves’ (strong openness and self-enhancement) experienced stronger autonomy but a lower positive relationships; ‘Post-materialists’ (openness and self-transcendence), experienced stronger autonomy and positive relationships; ‘spiritual traditionalists’ (conservation and self-transcendence), had higher sense of personal growth and positive relationships; and the ‘undecided’ (no dominating value set) experienced lower autonomy and personal-growth.     

Quality of life and social support of patients being evaluated for bone marrow transplantation

A sample of 437 patients completed self-report measures of quality of life and social support while they were being evaluated for bone marrow transplantation (BMT) at The Johns Hopkins Oncology Center. Generally, the candidates showed reasonably high levels of quality of life (QOL) on the Satisfaction with Life Domains Scale (SLDS), their present ranking on the Cantril Self-Anchoring Ladder of Life, and their scores on the Bradburn Positive Affect Scale. The level of QOL of these candidates for transplant was significantly related to their level of social support. Both availability and adequacy of social support for these transplant candidates were found to be significantly related to QOL as measured by the SLDS. Availability of social support as measured by patient membership in religious and other organizations was significantly related to Positive Affect but not Negative Affect. The Family APGAR and Relational Support Scales measures of social support were significantly correlated with both Positive and Negative Affect.     

Donating organs: a theory-driven inventory of motives

Two studies examined the motives that lay behind patients' acceptance or reluctance at donating organs after death. They also examined the way these motives were related to demographic characteristics, personality, and signing a donor card. Six separable motives for donation were found: Financial Incentive, Humanistic or Religious Duty, Positive Consideration from Others, Living on Through a Receiver, Gift of Life, and Close Others. Five motives for not donating were found: Preserving the Absolute Integrity of the Corpus, Strict Individualism, Lack of Control over the Use of the Organs, Anonymity of the Procedure, and Respecting Family Wishes. These motives were linked to personality factors in a meaningful way. Willingness to sign was higher among female participants and among participants with lower scores on Integrity of the Corpus and higher scores on Duty and Gift of Life. When Integrity of the Corpus scored highly, however, the effect of the other factors was practically eliminated. In other words, Integrity of the Corpus acted as a protected value: Trying to change people's belief that the integrity of the corpus at death is a sacrosanct issue would come with its own ethical issues.     

Books Received

Includes brief reviews of the following books:
Analytical Psychology
Segal, R. A., Jung on Mythology.
Stevens, A., An Intelligent Person's Guide to Psychotherapy.
Von Franz, M-L., Archetypal Patterns in Fairy Tales.
Psychoanalysis
Geissman, C. & Geissmann, P., A History of Child Psychoanalysis.
Psychotherapy
Lomas, P., Personal Disorder and Family Life.     

A longitudinal examination of couples' coping strategies as predictors of adjustment to breast cancer

This study's goals were to examine coping strategies of women and their male partners as predictors of change in women's adjustment over the year following breast cancer treatment and to test whether partners' coping processes interact to predict adjustment. In a sample of women who had recently completed breast cancer treatment and were taking part in a psychoeducational intervention trial, the patients' and partners' cancer-specific coping strategies were assessed at study entry (average of 10 months after diagnosis). Assessed at study entry and 20 months after diagnosis (n = 139 couples), dependent variables were women's general (i.e., vitality, depressive symptoms, relationship satisfaction) and cancer-specific adjustment (i.e., cancer-specific distress, perceived benefits). Both patients' and partners' coping strategies at study entry predicted change in women's adjustment at 20 months. Women's use of approach-oriented coping strategies predicted improvement in their vitality and depressive symptoms, men's use of avoidant coping predicted declining marital satisfaction for wives, and men's approach-oriented strategies predicted an increase in women's perception of cancer-related benefits. Patients' and partners' coping strategies also interacted to predict adjustment, such that congruent coping strategy use generally predicted better adaptation than did dissimilar coping. Findings highlight the utility of examining patients' and partners' coping strategies simultaneously.     

Altered Sexuality and Body Image after Gynecological Cancer Treatment: How Can Psychologists Help?

Once medical treatment for gynecological cancer is completed, what happens to patients' sexuality and body image? Due to the delicate nature of the cancer site, treating this cancer typically affects sexual functioning and body image adversely, making it critical to identify the concerns of these patients and do so in a manner less restrictive than paper-and-pencil assessment. To gain a deeper understanding of the phenomenological experiences in question, we interviewed nine gynecological cancer patients and seven cancer-free women. After implementing a relaxation protocol, we asked each woman to describe her feelings and thoughts on her sexuality and body image in one-on-one interviews. A variety of themes emerged on patients' attitudes and perspectives concerning sexuality and body image following diagnosis and treatment of the cancer. The themes that were considerably different from those of the cancer-free women included decreased sexual functioning and body image, abrupt shifts in self-identity due to loss of physical integrity, and distancing in intimate relationships. Several implications of these findings for clinical practice are discussed, as well as the need to train medical professionals to properly assess these patients' alterations in sexuality.     

Health-related Quality of Life,Fatigue, and Posttraumatic Growth of Cancer Patients Undergoing Radiation Therapy: A Longitudinal Study

The purpose of this study was to determine health-related quality of life (HRQoL), fatigue, and posttraumatic growth (PTG) among patients with breast or prostate cancer during and following radiation therapy (RT). A total of 91 patients completed measures at three time points as follows: one or two weeks before the start of RT, in the fifth/sixth week of treatment, and four to six weeks post-treatment. Consistent with the previous literature, the results of this study revealed that RT was associated with declines in global HRQoL, Physical Well-being, Social/Family Well-being, and Functional Well-being, as well as an increase in fatigue. By four to six weeks post-treatment, these factors improved significantly and returned to baseline levels with the exception of Social/Family Well-being. The PTG total score and almost all of its subscale scores did not change significantly during the period of the study. However, the subscale of Spiritual Change for PTG significantly increased during the RT, and sustained this improvement at four to six weeks post-treatment. A significant negative correlation was found between Physical Well-being and PTG total score, whereas a significant positive correlation was revealed between Social/Family Well-being and PTG total score. The results from this analysis suggest that a significant decrease in HRQoL is evident in the fifth/sixth week of RT treatment. However, recovery of HRQoL occurs as quickly as a few weeks after the end of treatment. Moreover, patients with high ratings of Social/Family Well-being experience more positive psychological changes (PTG) resulting from the cancer experience.     

Family and food variables that influence life satisfaction of mother-father-adolescent triads in a South American country

This study explored the influence of each family member’s life satisfaction on the other family members’ life satisfaction in mother-father-adolescent triads. We also explored the influence of each family member’s satisfaction with food-related life and family life on their own life satisfaction (LS) as well as on the other family members’ LS in mother-father-adolescent triads. The influence of family eating habits, food-related parenting practices used by each parent and sociodemographic characteristics on each family member’s LS were also explored. A survey was applied to a sample of 300 two-parent families with one child between 10 and 17 years of age in Temuco, Chile. The questionnaire included the Satisfaction with Life Scale, Satisfaction with Food-related Life scale, Satisfaction with Family Life scale, Adapted Healthy Eating Index, Family Food Behavior Survey and Family Eating Habits Questionnaire. Frequency and sources of family meals as well as sociodemographic characteristics were also consulted. Three multivariate ordinal logit models were proposed, with the dependent variable LS in the three subsamples: mothers, fathers and adolescents. The three logit models were significant, but differed in the explanatory variables. Mothers’ LS was influenced by their children’s LS and vice versa. Mothers’ LS was positively influenced by both their own satisfaction with family life and the fathers’ satisfaction with family life and vice versa. Children’s LS was also positively influenced by their own satisfaction with food-related and family life. Both parents’ LS was influenced by eating habits, food-related parenting practices and sociodemographic characteristics, but in different ways. Therefore, different interventions should be implemented to improve each family member’s life satisfaction.

     

Social support and cancer: Adult patients' desire for support from family,friends, and health professionals

Examined cancer patients' desire for social support from family, friends, and health professionals upon whom they most depended for support. Before a single interaction with each of these sources, nonhospitalized adult cancer patients (N = 64) completed a questionnaire indicating their desire for support from the source on 11 functional components. Results indicated that emotional and instrumental functions of support were distinct and required separate examination. Distinctiveness of primary sources was manifest by patients' overall preference for tangible aid from family, modeling from friends who had cancer, and open communication and clarification from health professionals. Family and friends were equally preferred sources for dealing with affective reactions to the stressfulness of cancer. All three sources were similarly desired for self-esteem enhancement and for relief from decision-making and problem-solving responsibilities. Finally, patients' perceived prognosis but not the objective severity of their illness was associated with a heightened desire for support, especially for instrumental support functions.     

Book reviews

Helen B. Landgarten, Family Art Psychotherapy: A Clinical Guide and Casebook
David Greenwald and Steven J. Zeitlin, No Reason to Talk About It. Families Confront the Nuclear Taboo
Ammy van Heusden and ElseMarie van den Eerenbeemt, Balance in Motion. Ivan Boszormenyi-Nagy and His Vision of Individual and Family Therapy
Wilf Fox, Parental Participation in Child Care Planning. Social Work Monographs
Peter Steinglass, Linda Bennet, Steven Wolin and David Reiss. The Alcoholic Family
Robin Skynner (edited by John R. Schlapobersky), Explorations with Families: Group Analysis and Family Therapy
John D. Friesen, Structural-Strategic Marriage and Family Therapy
Jurgen Ruesch and Gregory Bateson, Communication: The Social Matrix of Psychiatry
Joyce C. Mills and Richard J.Crowley, Therapeutic Metaphors for Children and the Child Within
Peter Riches (Ed.), Children and Society
Michael P. Nichols, The Self in the System: Expanding the Limits of Family Therapy
Cyril Greenland, Preventing 'CAN' Deaths: An International Study of Deaths due to Child Abuse and Neglect
Judith Lowe, Social Work and Angry Parents
John Corden and Michael Preston-Shoot, Contracts in Social Work
Arlene Vetere and Anthony Gale, Ecological Studies of Family Life     

Book reviews

Peter Bruggen and Charles O'Brien, Helping Families: Systems, Residential and Agency Responsibility
Robert Shaw, Children of Imprisoned Fathers. Great Britain
C. Lewis and M. O'Brien (Eds), Reassessing Fatherhood: New Observations on Fathers and the Modern Family
Robert Wilkins and Penny Loudon, The Therapist's Thesaurus: A CartoonGuide
Uma Sekaran, Dual-Career Families, Contemporary Organization and Counselling Issues
Yvette Walczak and Sheila Burns, Divorce: The Child's Point of View. Harper and Row, 1984
James Youniss and Jacqueline Smollar, Adolescent Relations with Mothers, Fathers, and Friends
Florence W. Kaslow and Lita Linzer Schwartz, The Dynamics of Divorce–a Life Cycle Perspective
Sue Waldron-Skinner and David Watson (Eds), Ethical Issues in Family. Therapy
R. Kennedy, A. Heymans and L. Tishler (Eds), The Family As In-Patient. Families and Adolescents at the Cassel Hospital     

Socioeconomic,family, and social stress correlates of adolescent antisocial and delinquent behavior

A total of 84 male and female adolescents were surveyed for SFS, family systemic functioning, and four types of social stress (Induced Transitions, Daily Hassles, Developmental Transitions, and Circumscribed Life Events) in relation to level of antisocial and delinquent behavior to determine the individual and cumulative effect of these psychosocial predictors. Univariate analyses indicated that perceived and Desired Family Cohesion, Daily Hassles, Circumscribed Life Events, and Developmental Transitions correlated significantly with reported antisocial and delinquent behavior, but SES and gender did not. Multivariate analyses affirmed that SES was of little use in understanding such behavior, at least among the general population, and that family functioning and social stress contributed interactively. Desired Cohesion was the most reliable indicator, with other family and stress variables' importance differing for males and females. These findings suggest that a family's ability to support each other and to harness that support to cope with transitions and stress during adolescence relates to a lower level of antisocial behavior.     

Quality of Life and Coping of Women Treated for Breast Cancer and Their Caregiver. What are the Interactions?

This longitudinal study analyzed the interactions between the quality of life and the coping strategies of 100 patients treated for breast cancer and their caregivers. Data were collected after diagnosis, at the end of treatment, and 6?months after treatment with the Quality of Life Questionnaire-C30 (QLQ-C30), Duke Health Profile and Ways of Coping Checklist for both patients and caregivers. The theoretical model was tested using a typology of patients and mixed model analyses. The quality of life of patients changed over time and no cluster effect was found. The influence of the sociodemographic characteristics, coping strategies (patients and caregivers) and the quality of life of caregivers on patient's quality of life were different according to the quality of life dimensions considered. To understand the adaptation of patients to their disease, it is therefore essential to look at whether the caregiver is capable of playing a supporting role.     

Notes on unintegration and disintegration from historical and developmental perspectives

Frances Tustin: Autistic States in Children, Published by Routledge and Kegan Paul Ltd. 1981 Price £12.50.

B.A. Farrell The Standing of Psycho-Analysis Published by Oxford University Press. 1981. Price £3.95.

Helen Featherstone: A Difference in the Family. Life with a Disabled Child. Published by Basic Books Inc. 1980.

Martin Richards: Infancy. World of the Newborn. The Life Cycle Series. Published by Harper &; Row. 1980. Price £2.25 (paperback).

Jerome Bruner: Under fives in Britain. Published by Grant McIntyre. 1980. £10.95 (hardback), £4.50 (paperback).     

Gender Differences in the Importance of Work and Family Roles: Implications for Work–Family Conflict

In this study we explored between- and within-gender differences in the importance of life roles and their implications for work–family conflict. In earlier research (Cinamon & Rich, 2002) we found 3 profiles of workers who differ in attributions of importance to work and family roles: persons who assigned high importance to both the work role and the family role (“Dual” profile); participants who ascribed high importance to the work role and low importance to the family role (“Work” profile); and participants who attributed high importance to the family role and low importance to the work role (“Family” profile). We used these profiles to clarify the relationship between gender and work–family conflict. Participants were 126 married men and 87 married women who were employed in computer or law firms. Significant between- and within-gender differences were found in the distribution of participants to profiles. Men were equally distributed throughout the profiles, whereas women were underrepresented in the Work category. More women than men fit the Family profile, and more men than women fit the Work profile. No gender differences were found for the Dual profile. Women reported higher parenting and work values than men did. Between-gender differences in work–family conflict were apparent, as were within-gender differences across profiles. Results demonstrate the value of examining both between- and within-gender variation in studies of gender and work–family conflict.     

Change in values and moral reasoning during higher education

The aim of this study was to examine whether personal value priorities, measured by Schwartz et al.'s method, change during higher education, whether moral reasoning measured by the DIT develops and whether values predict gain in moral development. Moreover, we explored the simultaneous changes in value priorities and moral reasoning. Our sample consisted of 132 students from a university of applied sciences who filled out the value measure and the DIT both at the beginning and at the end of their studies. The results revealed that universalism and security values became more important whereas achievement decreased in importance during the three-year period. We also found significant gain in moral development and that universalism and hedonism values predicted this gain significantly. Significant correlated change was found between moral reasoning and stimulation, conformity and security values. The meaning of the results is discussed in terms of the theories of Schwartz and Kohlberg.     

Quality of life and family functioning in schizophrenia patients

Quality of life and family functioning of patients with schizophrenia are described. A sample of 49 schizophrenic patients and their 70 relatives, treated at the Mental Health Services of Arica, Chile, were included in the study. The Quality of Life Questionnaire of Sevilla (CSCV), the General Health Questionnaire (GHQ-12) and the Family Function Questionnaire (APGAR) were used to assess the patients, the last one also administered to their caregivers. Contrary to the results found in researches done in developed countries, the patients of this sample indicated suitable levels of quality of life, to a great extent, related to the perception of their family functioning. This confirms the importance of the family as social network of emotional support. Nevertheless, perceived family functioning is different in patients and their caregivers. Higher scores were obtained in caregivers who participated in a family psychoeducational program. The conclusion reached was that there are differences in the levels of quality of life perceived by patients of developed countries and those of developing countries, being higher in the latter ones, despite limitations in economic, sanitary and community resources. Future research should study why the variables that explain these levels of quality of life differ.     

“This is. That was.” Examining a Family’s Lived Experiences After a Cancer Diagnosis

In 2015, 231,840 American women were diagnosed with invasive breast cancer. This figure represents mothers, wives, or sisters diagnosed with cancer, a diagnosis which has the potential to affect those closest to them, especially their immediate family. This research aimed to examine the lived experience of a family unit that lost their spouse/mother/sister-in-law to invasive breast cancer. A phenomenological case study was utilized to guide this research. One family unit, consisting of a spouse, daughter, son, and sister-in-law to the deceased were recruited from Southern Ontario, Canada. Background questionnaires and one-on-one semi-structured interviews were conducted. The following themes emerged: (1) negatives, describing struggles with balancing care, faith, and living after a death in the family and (2) silver linings, depicting the strength that Nancy, the deceased, maintained during her illness, and the family’s hope and optimism for the future. This paper only addresses the theme “Negatives,” while the last theme is addressed in Part II of this research. Within the theme “Negatives,” there were four sub-themes: (1) What About the Kids? (2) The Balancing Act, (3) Why Would He Do This? and (4) Life After Mom. Each will be discussed in turn. This research study provides valuable information regarding the lived experiences of families coping with a parental/spousal cancer diagnosis. It may assist other individuals in similar situations by providing comfort knowing that they are not the only ones encountering this journey. The participants’ voices may also allow others to develop strength by understanding the effect of cancer on a family.     

On wisdom

This article explores some of the features involved in making wise decisions in couples and family therapy. Delineating what qualities are involved in making wise decisions in life--so as to live the "good life" in the polis, and the necessary contributions of life experiences in this task--was first discussed by Aristotle. A major problem that therapists face today is that our society offers many different ways of living well--or for that matter, badly--and our theories do the same. Family therapy theories are not value free. I clarify that different family theories embody different values: clear boundaries, good attachments, the ability to communicate, and so on. If our theories foster certain values, then, as Isaiah Berlin has made clear, seeking to achieve a particular value leads to placing less value on another. The article concludes with some thoughts about values that therapists could appropriately follow in their work.