Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

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.     

Intergroup fairness and bias in children

In recent years in research on intergroup relationships, the assumption has increasingly been made that discrimination dominates decisions when individuals allocate resources between (members of) own and other group. Conversely, in empirical studies of interpersonal decision-making, including an extensive literature on the development of children's allocation rules within dyadic relationships, it has been repeatedly observed that in dyadic relationships choices though responsive to various changes in the environment, are more strongly governed by fairness rules. The present research extends the interpersonal fairness paradigm to the intergroup case, and examines the effects of some of those variables, namely, children's age, input and attitudes toward other, that have been observed to influence choice behaviour within interpersonal relationships. The findings indicate that as children are socialized, fairness rules also play an increasing dominant role in intergroup allocation decisions, and that both relative input and the language of the outgroup influence such decisions. At the same time, there is some preliminary evidence to indicate that the relative strength of self-interest may be somewhat stronger in intergroup than in interpersonal relationships. Finally, a number of the issues that must be confronted in comparing the two more important forms of human social choices, interpersonal and intergroup decision-making, are considered.     

Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.