Children and Adolescents with Medically Unexplained Symptoms: A Systematic Review of the Literature

Abstract

Medically unexplained symptoms (MUS) in children and adolescents are confounding and concerning for patients, parents, and health care practitioners. Our goal was to review and summarize the literature for family therapists working with a diverse, challenging patient population coping with MUS. A search of multiple databases from 1994 to 2018 was conducted using MUS and related terms. The literature was then organized into subcategories based on its relevance to family therapists, particularly medical family therapists collaborating with primary care physicians. We conclude with a discussion about gaps in the literature and suggestions for clinical management.     

Family Structure: Its Effects on Adolescent Attachment and Identity Formation

This quantitative study examines the association between family structure, attachment, and identity formation. Results partially support the hypotheses and indicate that unresolved spouse conflict is associated with low levels of attachment in adolescents and attachment to father is linked to identity achieved and the diffused identity status. Lastly, parental coalition was inversely related to the moratorium and diffused identity statuses. These findings support a link between parent/adolescent relationships and the identity formation process. Directions for future research and clinical implications are also discussed.     

The Effects of Differentiation and Attachment on Satisfaction and Acculturation in Asian-White American International Couple Relationships: Assessment With Chinese,South Korean,and Japanese Partners in Relationships With White American Partners in the United States

The purpose of this study was to examine the effects of differentiation and attachment on acculturation and relational satisfaction in Asian partners in Asian-White American international couple relationships. Eighty-seven native-born Chinese, South Korean, and Japanese partners within an international couple relationship with a White American partner in the United States participated in this study. Regression results supported the hypotheses that differentiation and acculturation were significantly related to relationship satisfaction. Differentiation was also significantly associated with acculturation. Attachment style was not significantly associated with levels of relationship satisfaction or acculturation. Overall, the researchers found that differentiation and acculturation were important factors influencing the relationship satisfaction in Asian-White American international couples in the United States. Implications for practice and future research are discussed.     

Caring for Aging Parents: The Influence of Family Coping,Spirituality/Religiosity,and Hope on the Marital Satisfaction of Family Caregivers

The goal of this study was to gain a more complete understanding of the marital satisfaction of family caregivers based on a strength-based framework of family resiliency. Previous research has identified a relationship between the caregiving experience and coping, spirituality/religiosity, and hope, but no study to date has investigated the effect of those three variables on the marital satisfaction of family caregivers. We hypothesized that family caregivers who are spiritual/religious, hopeful, and use effective family coping strategies would experience greater marital satisfaction. A hierarchical linear regression analyzing data from 191 family caregivers supported the hypotheses. Implications for clinicians are discussed.     

Self and Other Ratings of Dyadic Empathy as Predictors of Relationship Satisfaction

In this study, self and other ratings of dyadic empathy are proposed to predict relationship satisfaction. One-hundred and fifty-one individuals over the age of eighteen who were in a relationship of at least six months in length at the time of the survey completed the Interpersonal Reactivity Index for Couples (Péloquin & Lafontaine, 2010) and the Couples Satisfaction Index (Funk & Rogge, 2007). Total scores for self and other rated dyadic empathy as well as scores of the congruity between self and other were assessed for each respondent. The results indicated that total perceived dyadic empathy and perceived dyadic empathic congruity were significant predictors of relationship satisfaction.     

The Process of Constructing Main Ideas From Text

A discourse-analytical approach to children's knowledge is offered, focusing on extracts of classroom talk between a teacher and a kindergarten class. After rejecting the possibility of defining concepts and memories as cognitive states prior to or underlying discourse, the talk is examined for how participants define and deal with such notions as a feature of the sequential and rhetorical organization of discourse. An argument is advanced for the analysis of knowledge, reality, and education as public, interactionally managed participants' concerns that can be studied as discursive practices. It is argued that the study of discourse does not ignore nondiscursive realms of mind and reality but permits analysis of how those things are defined, so that any explanatory appeal to what is beyond or behind the talk is unwarranted.     

The relationship between preretirement occupation and older adults' life satisfaction and self-rated health

Pensioners currently compose nearly 20% of the British population; men and women can expect to spend an average of about 17 years and 19 years in retirement, respectively. The present study aimed to investigate the roles of preretirement occupation and self-rated health (SRH) on the attainment of life satisfaction in retired people. A total of 121 community-dwelling men and women (M age = 75.8 years, SD = 7.1) completed a survey to assess life satisfaction, self-rated health, retirement stress, retirement adjustment, and recollected aspects of preretirement occupation. Results revealed positive and significant correlations between scores on a life satisfaction measure and SRH, retirement stress, and retirement adjustment (all ps < .001). Path analysis indicated that aspects of previous employment that may predict an adverse influence on current life satisfaction and that engagement in voluntary work appears to have benefits for both life satisfaction and SRH. The authors conclude that many of the adverse effects of preretirement occupation can be helped or avoided through suitable retirement preparation and training.     

Rape Myths: History, Individual and Institutional-Level Presence, and Implications for Change

Rape myths, which are present at both the individual and institutional/societal levels, are one way in which sexual violence has been sustained and justified throughout history. In light of an increasing accumulation of rape myth research across a variety of disciplines, this paper proposes to use a feminist lens to provide an overview of the historical origins of rape myths, to document the current manifestations of these myths in American society, and to summarize the current body of research literature. We focus on the history of several specific rape myths (i.e., ??husbands cannot rape their wives,?? ??women enjoy rape,?? ??women ask to be raped,?? and ??women lie about being raped??) and how these particular myths permeate current legal, religious, and media institutions (despite their falsehood). The paper concludes with suggestions for further research and describes how existing evidence could be used to aid in eradicating rape myths at both the individual and institutional levels.