Intergenerational Fusion and Nuclear Family Functioning

Bowen theory hypothesizes that undifferentiation or fusion between the generations influences nuclear family functioning. Using qualitative and quantitative methods this longitudinal study tested this idea with 49 newly developing nuclear families. Analysis of the first five years of data offered support to the hypothesis. Qualitative analyses of the participants' interviews gave the strongest support for higher levels of intergenerational fusion being associated with higher levels of nuclear family symptomology. Quantitative analyses also supported the hypothesis. The association between intergenerational fusion, as measured by couple-parent fusion and family financial dependence, and nuclear family functioning increased over the five-year period.     

The Multigenerational Transmission of Family Unit Functioning

Abstract

Bowen theory hypothesizes that a nuclear family's level of functioning is influenced by the stability or functioning of previous generations. This longitudinal study tested this hypothesis with 49 newly developing nuclear families and their multigenerational families. Family functioning was measured using a composite of physical, emotional, social, and marital symptoms of the family members of the current and previous generations. The quantitative analysis supported the hypothesis. In a correlation analysis of the first five years of this twenty-year study, multigenerational functioning, especially nuclear family of origin functioning, was associated with nuclear family functioning.     

Family of the forest: Fatal enmeshment and other systems issues in the animal world

While the observation of non-human animal behavior has been a major means of developing psychological theories, it has been rarely used by marriage and family therapists to devise or explain systemic ideas. Jane Goodall's multigenerational research on the Flo family of wild chimpanzees in Gombe, Tanzania, as presented in her own and other's writing, and especially in Hugo van Lawick's documentary film,People of the Forest, offers a clear example of how systems concepts' application to animal families may have theoretical, pedagogical, and clinical utility.My thanks to my good friend, Violet Richman, who suggested the subject for this paper.     

Family Ritual and Routine: Comparison of Clinical and Non-Clinical Families

Research demonstrates that the constructive use of family rituals is reliably linked to family health and to psychosocial adjustment. This study explores the relationship between family rituals and child well-being. Two samples participated: 21 families whose adolescent was receiving psychiatric treatment and 21 families in which the adolescent was a public school student. A parent and the adolescent were individually interviewed regarding family rituals and completed standardized measures of adolescent and family functioning. Analyses demonstrated that, in addition to significant sample differences in the expected direction on measures of functioning, the non-clinical families scored significantly higher on the index of family rituality than did the treatment families; this is additional evidence that family rituals are a correlate of child well-being. Further analysis of the data pointed to “people resources” as a robust dimension in its association to adolescent functioning. The role family ritual and routine plays in defining family relationships, both within the nuclear family and with other important adults, was significantly related to clinical status. This work may point to an important, yet overlooked, dimension of family ritual life, the relational qualities of rituals and routines.     

The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families

Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing.     

Paternal and Maternal Influences on Family Functioning Among Hong Kong Chinese Families

The linkages between dyadic relationships in the family and family functioning were examined in 378 Chinese families on two occasions. The following dyadic relationships were investigated: (a) parent-child relationship qualities reported by adolescent children (questionnaire and interview measures of parenting style, parent-adolescent conflict, parent-adolescent communication, and parent-adolescent relationship) and by their parents (questionnaire measures of parent-child relationship quality and demand); and (b) marital quality reported by the parents via questionnaire measures. Results showed that parents' and children's views of family functioning were longitudinally related to dyadic relationships in the family. Relative to mother-adolescent relationship and mothers' report of marital quality, father-adolescent relationship and fathers' report of marital quality were generally found to have a stronger association with perception of family functioning and its change over time.     

Distinguishing Caregiver Strain from Psychological Distress: Modeling the Relationships Among Child, Family, and Caregiver Variables

Although both have been used in studies of the impact of mental illness on the family, the constructs of caregiver strain (often referred to as burden of care) and psychological distress have not been clearly distinguished. The vagueness surrounding these constructs, and the lack of a cohesive conceptual framework for understanding how they relate, leads to contradictory interpretations of results. This compromises the building of the knowledge base needed to develop and evaluate interventions to support families as they struggle to meet the needs of their children with emotional and behavioral challenges. We utilized the ABCX Model as a framework for understanding caregiver strain and its relationship to psychological distress. Structural equations modeling was used to test the hypothesized relationship between caregiver strain and psychological distress, as well as the role of key child and family variables. These included child symptoms, stressful life events, social support, family functioning, and material resources. Our findings indicated that caregiver strain and psychological distress, although related, have distinct correlates and different implications in the family context.     

Relationship of Acculturation and Family Functioning to Smoking Attitudes and Behaviors Among Asian-American Adolescents

The primary objective of this study was to examine the combination of acculturation, family functioning, and parental smoking as predictors of smoking attitudes and behaviors among Asian-American adolescents. The participants were 106 Asian-American high school students whose ages ranged from 15 to 19 (51 male and 55 female, mean age = 16.30 years). Of the sample, 49% reported having tried smoking, and 27% identified themselves as regular smokers. The results indicated that smoking attitudes were significantly associated with smoking behaviors. Compared to nonsmokers, adolescent regular smokers had more positive smoking attitudes, lower acculturation, poorer family functioning and were more likely to have a father who smoked.     

Spouse and Family Functioning Before and After a Marine’s Suicide: Comparisons to Deaths by Accident and in Combat

The impact of service member suicides on families is not well understood. Civilian studies have demonstrated that family survivors of suicide deaths experience complicated grief, feel guilt and shame, and often do not receive sufficient social support. In this exploratory study, spouse survivors of Marines who died by suicide (N = 17), accident (N = 19), and in combat (N = 34) retrospectively reported on their immediate pre- and postmortem and current personal and family functioning. Nonparametric analyses revealed that several between-group differences existed. Observation of the means suggested that the spouses and families of Marines who died by suicide exhibited significantly poorer pre- and postmortem functioning compared with those whose spouses died in combat. Specific challenges included low family cohesion, high family conflict, perceived stigma, and shame. There were no differences in current spouse or family functioning, and there was weak evidence for posttraumatic growth among surviving spouses of those dying by suicide. These results should be considered preliminary and interpreted with caution given several methodological challenges.     

Family functioning and involvement in home visiting: Examining program characteristics as moderators to support retention in services

Developing strategies to improve retention in home visiting programs is critical to their success. The purpose of the study is to examine how the content provided during home visits moderates the association between family risks (economic, household functioning, and conflict) and retention in services. Parents (n = 1,322) voluntarily enrolled in Healthy Families America (n = 618) and Parents as Teachers (n = 704). Family characteristics were collected using the Family Map Inventories. Multilevel analyses showed a moderating impact of the time home visitors spent supporting parent–child interaction for all family risks examined. Moderating effects demonstrated a stronger positive association between focusing on the parent–child relationship and retention at 6 and 12 months for parents demonstrating greater needs. There were no moderating effects of child development content or case management activities with retention at 6 and 12 months. Together, families were more likely to stay in services when home visitors focused on parent–child interaction and child development, but less likely retained with more case management. Parents with greater risks were more likely to remain in services with more time focused on supporting parent–child interactions. Findings suggest the need to support our home visiting workforce in their work to promote healthy parent–child relationships.     

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

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

Family size and psychological functioning in the Orthodox Jewish community

Caring for children is a known psychosocial stressor; however, its effects on psychological functioning may have substantial cross-cultural variance. We explored relationships between family size and a variety of psychological outcomes among Orthodox Jews in four separate studies: (1) an international treatment-seeking sample (n?=?82), (2) a community sample from Canada (n?=?226), (3) an out-patient clinical sample from greater New York (n?=?82), and (4) a large dyadic sample of Israeli couples (n?=?789). Surprisingly, results suggested that family size was not associated with greater stress, anxiety, depression, global functioning, family functioning, family communication, family satisfaction, or even parenting stress. It is possible that the high religious value placed on family life as well as structural adaptions in families buffer against potential stressors associated with child rearing, and further research on these potential effects is warranted.     

A cross-cultural study of family functioning

The Family Assessment Device (FAD) was used to compare patterns of family functioning in two cultural settings, North America and Hungary. The sample size consisted of 95 nonclinical North American families and 58 nonclinical Hungarian families. No cross-cultural differences were found in the families' general functioning nor in their affective involvement or affective responsiveness as measured by the FAD. Hungarian families, however, perceived their functioning as significantly better than the North American families in problem-solving and in communication. North American families rated themselves significantly better than the Hungarians in setting family rules and boundaries and in meeting their family responsibilities. Results from this study suggest that cultural values can affect a family's functioning and that differences in areas of family functioning can be captured using the FAD. A discussion of broad societal values of the two cultures was used to interpret the contrasting patterns of family functioning.Cross-cultural studies serve many purposes. In general they provide knowledge about the different cultures under investigation. As such, they broaden and enrich our perspectives of ourselves and the world around us. More specifically they highlight similarities and differences across cultures, information that can be helpful in further refining our understanding of the impact of diverse and varying socio-political forces.A topic of particular interest to family therapists and researchers is family functioning in different cultural settings. In spite of continuing research in this area, few studies examine cross-cultural patterns of family interactions and even fewer do so with instruments specifically designed to assess family functioning.From a family perspective, particularly looking at pathology in family functioning, cross-cultural comparisons can be used to highlight areas of dysfunction common to families irrespective of the cultural context. From a cross-cultural perspective, family comparisons can be used to point out the cultural effects and emphases given to different dimensions of functioning within a common system (i.e., the family unit).Both conceptual and methodological problems have contributed to shortcomings in previous cross-cultural studies (Fabrega, 1974; Kleinman, 1987; Flaherty et al., 1988; Rogler, 1989). A basic criticism of such studies has been the assumption that meanings and values in one culture are equivalent to those in another.Another issue, which is particularly pertinent to our study, is the use of an instrument which is developed in one culture and administered in another cultural setting. A potential problem this raises is inferring cultural differences between groups when the translated and the original instruments are not actually comparable in meaning. In fact, one objective of the study was to see whether our own self-report measure of family functioning, the Family Assessment Device (FAD, Epstein et al., 1978, 1983), could be successfully used in another cultural setting.The following report is part of a larger research project, conducted in 1986–87, that compared depressed and nonclinical families across two cultures. The findings presented here are comparisons between nonclinical Hungarian and nonclinical North American families. In our earlier study differences in family interactions between clinically depressed and nonclinical families were evident in both cultural settings (Keitner et al., in press). It was not clear, however, if significant cross-cultural differences in family functioning would be found for the normal group of families and, if so, how these would differ from their ill counterparts. Inclusion of the normal families thus served two purposes, as controls in the larger study to test within cultural differences and as comparison groups in a separate analysis to test between cultural differences.A specific objective of this study was to contrast patterns of perceived family functioning in nonclinical Hungarian families and North American families. Another objective was to determine if the Family Assessment Device (FAD), a self-report measure of family functioning, could be successfully used in different cultural contexts. Hungary was chosen as an appropriate country of study for several reasons. It is at the crossroads of East and West, sharing enough similarities with western culture to validate comparisons, yet different enough in both its cultural and sociopolitical system that some differences could be expected to emerge. Because it is likely that the Hungarian social system is less familiar to readers than that of North American, the results are discussed with particular reference to Hungary.We would like to thank Drs. J. Furedi and T. Kurimay for help in translating the Family Assessment Device and Professors J. Szilard and Muszong-Kovacs for their support of this study. This work was supported in part by the Firan Foundation.     

Family-based physical activity interventions and family functioning: A systematic review

Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5–12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father–son, mother–daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent–child dyads), is recommended in order to better ascertain the effectiveness of these approaches.     

The truncated nuclear family

The truncated nuclear family is defined: it is the garden-variety family pathology found. The critical role of polarized continuity and discontinuity values in producing the truncated nuclear family is discussed. There is a brief review of factors in American society which, over the decades since the Second World War, have evolved the nuclear family as a dominant family unit, and of how those and other factors in society have produced the large numbers of truncated nuclear families seen in clinics, particularly in the past decade. Family therapy is the treatment of choice for the truncated nuclear family, provided there is a readiness of the family to undertake the stress of therapy.Dr. Zuk is family therapy consultant to agencies in New Orleans and elsewhere, and clinical professor (psychology) in the Department of Psychiatry and Neurology at Tulane University Medical School.This paper is a chapter in the forthcoming 2nd edition ofProcess and Practice in Family Therapy, to be published by Human Sciences Press of New York City in 1985.     

Using selection,optimization, and compensation to reduce job/family stressors: effective when it matters

Previous research has demonstrated that the use of general behaviors specified by a life-management strategy entitled Selection, Optimization, and Compensation (SOC) reduces, if only to a small extent, the perceived amounts of the main antecedents (i.e., job/family stressors) of work-family conflict. The results of the current study demonstrate that several variables that impact the amount of resources demanded of, or resources available to, an individual (e.g., supervisor support) moderate the relationship between SOC behaviors and job/family stressors. Specifically, SOC strategies are more effective than previously thought at reducing job/family stressors for precisely those individuals in the most demanding situations.     

Familienfunktionalität und Therapieerfolg

Background

Even though it is a treatment standard of child psychotherapy to involve the parents, hardly any research has been carried out about the impact of family functioning on treatment outcome. Aims of the present study were to investigate the change in and the prognostic power of family functioning on treatment outcome of short-term psychodynamic psychotherapy in children and adolescents.

Patients and methods

The sample consisted of 54 children and adolescents undergoing outpatient short-term psychodynamic psychotherapy. To assess family functioning, their parents were asked to complete the Family Assessment Measure (FAM).

Results

Patients from families with high levels of functioning in task accomplishment, communication and affective expression were more often treated successfully. Improvement in levels of functioning in role performance, emotionality and control were only found in the group of successfully treated patients.

Conclusion

Family functioning is a decisive factor in the differential indication of psychotherapeutic treatment in children and adolescents.     

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.     

Six Years in the Cognitive and Metacognitive Life of 71 Families

Seventy-one families from a low socio-economic background, each with a son at risk of developing psychosocial problems at the onset of the study, were observed three times over a six-year period while solving a combinatorial task presented on a microcomputer. The permutations task was used to gather information with regard to cognitive functioning and cognitive self-regulation of the families, which were observed as a developmental unit. Cognitive functioning was assessed according to three variables: cognitive strategies, performance, and completion of the task. Six self-regulatory activities were assessed: task definition, planning, supervision, evaluation, parental support, and sharing of responsibilities. Although inefficient strategies were mainly used across the six years, the cognitive level of functioning improved over the years. Cognitive self-regulatory activities most often used across time were supervision and parental support. Differences were observed in the three time periods for supervision, task definition, parental support, and individual involvement. Results indicated a link between cognitive strategies used by the families to solve the task and their self-regulatory activities. Results are interpreted within both the Piagetian and Vygotskian perspectives. Families' cognitive self-regulatory activities observed in this study are an example of parental disengagement and children's growing involvement in a joint activity.