The effect of family variables on child weight change

Previous research has shown that family size, the number of obese persons living at home, and parental weight influence the development of childhood obesity. Our study reports the relevance of these factors to child weight loss during a 1-year treatment period. Multiple linear regression procedures showed that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. These results suggest that family size may interact with treatment to determine weight change. The effects of family size on outcome may be operating simply by reducing the amount of time that a parent has to spend with the child in promoting behavior change. Likewise, increased family size may be operating as a stressor, reducing the effectiveness of parents in effectively managing their children.     

Assessment of suitability for low-fee control psychoanalysis: some theoretical and technical considerations

In the assessment of suitability for low-fee control analysis, various factors may interfere with successful referral, evaluation, and disposition. Variables within the referring analyst, patient, candidate, and supervisor are examined in their interaction with the circumstances of the assessment enterprise. Issues of competence, self-esteem, and oedipal rivalry, as well as guilt feelings, concerns about rejection, and other conflicts may be mobilized and may prevent a successful outcome. Clinical data from three assessments are presented and discussed. The concept of an assessment process, analogous to the psychoanalytic process, is proposed. In this process, manifestations of the patient's intrapsychic life and indicators of potential transferences emerge in the context of the analysis of the patient's reactions to the assessment. Potential sources of interference with the assessment process are identified, and measures to avoid them are suggested.     

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.     

Social and personal adjustment of elementary and secondary students

The present study examined school adjustment problems of about 1000 students aged 6 through 17 years. The Behavior Problem Checklist was factor-analyzed to identify multivariate factors of adjustment problems. Age- and sex-based subgroups were then compared on these factors, and some estimates of criteria for abnormality were derived. Finally, the prevalence of each problem on the checklist was derived separately for age- and sex-based subgroups, which were then contrasted on the items. The results provide basic information about the adjustment problems of those students who are not considered socially or personally maladjusted.     

Intermittent low-calorie regimen and booster sessions in the treatment of obesity

The present study investigated two new weight-control strategies: an intermittent low-calorie regimen and intermittent scheduling of booster sessions. A new approach to predicting patient weight loss, based on a pretreatment assessment with a highly-structured eating regimen, was also studied. Forty-eight obese patients were randomly assigned to either a Standard Behavioral weight-control condition or to an Intermittent Low-calorie Regimen (< 750 cal for 2 days/week) condition and to one of two maintenance schedules: a Spaced schedule in which the six booster sessions were held at monthly intervals, or a Massed schedule, in which four of the six meetings were held during the third month. Neither the intermittent low-calorie regimen nor the intermittent scheduling of booster sessions significantly affected weight loss. However, weight loss at 1 year was related to compliance to self-monitoring and to self-reported change in eating habits and exercise. In addition, weight loss at 1 year was related to weight loss during the initial pretreatment assessment period.     

Where is the “D” in dissonance?1

The experiment tested the hypothesis that cognitive dissonance has a general drive arousal component which facilitates performance on simple cognitive tasks and impairs performance on complex cognitive tasks After writing a consonant or a dissonant essay dealing with proposed changes in university parking regulations, subjects were given either a simple or a complex task (rote memory or creativity). To maximize dissonance, free choice regarding participation was deliberately emphasized, resulting in a high proportion of subjects who refused to comply with the request Data from refusers were retained and compared with data obtained from compliers Appropriate control groups were employed in order to ascertain whether the results were attributable to the process of self-selection among complier and refuser subjects The dissonance manipulation was successful subjects who wrote dissonant essays subsequently displayed more favorable attitudes toward the parking proposal Their performance on complex cognitive tasks was not unpaired, however, nor did they perform better on simple cognitive tasks than did subjects who experienced no dissonance Subjects who refused to write dissonant essays did better on the complex task than subjects who complied in either the consonant or dissonant conditions Data from the control groups indicated that refusers did not differ from compliers in their initial attitudes toward the proposal nor in their ability to perform the complex cognitive task The results seem to be due to the facilitating effects of refusing to comply with the dissonance instructions, and suggest that the practice of eliminating subjects who refuse to comply may result in the loss of some highly informative data