The "psychosomatic family" model: an empirical and theoretical analysis

Evolution of the Family Systems Paradigm has been constrained by the dichotomy between theory building and empirical research. This article integrates these two domains by presenting a theoretical analysis of the "psychosomatic family" model as it informs and is informed by an empirical research project. Forty families of children with Crohn's disease (CD), ulcerative colitis (UC), and functional recurrent abdominal pain syndrome (RAP) were rated during standard, videotaped family interaction tasks, lunch, and interview. Laboratory scores of disease activity were associated with triangulation, marital dysfunction, and total "psychosomatic family" scores. Disease activity was not significantly correlated with enmeshment, overprotection, rigidity, conflict avoidance, or poor conflict resolution. Thus, the marital/triangulation and enmeshment/overprotection/conflict clusters may be subcomplexes of the "psychosomatic family" complex. CD, UC, and RAP groups differed in the relations among particular family patterns and disease activity. A heuristic family-psycho-somatic model is presented to facilitate future research.     

Profile analysis of standardized intelligence test performance of very low functioning individuals

Practitioners are frequently faced with the need to evaluate the intellectual skills of individuals with very low levels of functioning. Owing to the statistical rarity of these persons, few tests have sufficient range of scores for a detailed analysis of intraindividual differences in performance. This paper describes a method that uses are equivalents and standard scores to recreate the full range of variability in the scores of low-functioning individuals. The method allows for a more complete interpretation of performance that can lead to better educational and therapeutic programming.     

Neuroticism,life stress and concern about eating,body weight and apperance in a non-clinical population

Studies with clinical populations have shown a high level of neuroticism amongst those with an eating disorder. It is unclear however whether the elevated neuroticism is a function of the disorder, or if it is an aetiological factor in the disorder's development. The present survey of a non-clinical female population revealed that those high in neuroticism gave higher—but not abnormally high—scores on a measure of concern about eating. The high-N group also reported a significantly greater number of undesirable life events; a greater familiarity with ‘diet literature’; increased dieting; but no difference in body weight from those in the middle and lower ranges on the N scale. On the basis of these findings it is suggested that neuroticism is an aetiological factor in disordered eating, at least with secondary if not primary disorders. It is propesed that neuroticism is one mediating psychological factor in a triadic relationship between personal environment contingencies, socio-cultural pressures for thinness and psychological variables. Suggestions are made for future investigation of the role of neuroticism in eating disturbance, with note of potential therapeutic application of such knowledge.     

Proximity and hierarchy: orthogonal dimensions of family interconnectedness

The purpose of this research was to develop logical and empirically valid conceptual tools for investigating relationships between family patterns of interconnectedness and psychosocial functioning of children in the family. The family systems concept of boundary was analyzed into two component concepts: Proximity (interpersonal boundaries) and generational Hierarchy (subsystem boundaries). These concepts were operationalized as dimensions, and eight families were assessed by means of interaction coding, interview, and Kinetic Family Drawing to yield empirical verification of these dimensions. Findings indicated that Proximity and Hierarchy are reliable, valid, and independent dimensions of family interconnectedness. Weak generational Hierarchy was associated with increased levels of psychological dysfunction for both identified patients and their siblings. High Proximity was similarly associated with psychological dysfunction, but only for identified patients. The hypothesis that enmeshment is a composite pattern of high Proximity and weak Hierarchy was disconfirmed. Suggestions for future research include systemic analysis of deviation-counteracting and -amplifying relationships between patterns of Proximity and Hierarchy, on the one hand, and psychosocial dysfunction, on the other.     

The Social Psychology of Caregiving: Physical and Psychological Costs of Providing Support to the Disabled1

The emphasis of much of the existing research on social support-health relationships has been on the availability and impact of support on the recipient, but social psychologists have paid little attention to the costs to the caregiver of providing that support. In an earlier study (Schulz & Decker, 1985), we found that the long-term coping of individuals experiencing chronic disability as a result of spinal-cord injury was facilitated by the availability of a primary support person, or caregiver. In this study we examined the determinants of well-being of the primary caregiver of the middle-aged and elderly spinal-cord-injured persons. Psychological well-being, life satisfaction, and depression were the dependent measures. The availability of social support, social contact, and feelings of control over one's life were important determinants of caregiver well-being, even after controlling for health and income. In addition, the amount of time spent each day assisting the disabled person was a strong independent correlate of depression, and the extent to which the caregiver felt burdened by the victim was significantly and negatively related to life satisfaction. These results are discussed in the context of a comprehensive stress-coping model. Since data were available from both disabled individuals and their primary support persons, we had the unique opportunity to compare the perspectives of both those giving and receiving daily care. We found no relationship in levels of psychological well-being and depression reported by the disabled person and caregiver; however, caregivers attributed to the victims affective levels similar to their own.     

Separate verbal memory and naming deficits in attention deficit disorder and reading disability

In this study, verbal memory and naming abilities were investigated in reading disabled (RD) and control children who were characterized according to the presence or absence of attention deficit disorder (ADD). Results indicate that deficits in learning and memory for recently acquired information occur as a function of ADD rather than RD while deficits in naming are specific to RD rather than ADD. We conclude that ADD is a major source of additional and separate cognitive morbidity in RD children.     

Later stages in Experiential Marital Therapy

This is the second of two papers dealing with symbolic-experiential treatment of marital issues. The first—Early Stages in Experiential Marital Therapy — discussed three early stages. This paper discusses regressive work with couples, including engagement with the family of origin.     

Wilderness family therapy: Experiential dimensions

This paper describes the process in which families participate in a wilderness experience. Metaphors such as climbing or paddling a canoe are translated into daily living patterns to deepen individual and family self-knowledge, self-esteem, and intimacy.     

“Marital trap analysis”—incompetence,complementarity, and success traps: Identifying potential future dysfunctions based on a couple's current collusive agreements

This paper describes three types of traps or collusive marital agreements-incompetence traps, complementarity traps, and success traps-in which the mates renounce or forgo competent functioning in vital areas of marital roles and experience. It is suggested that responsible clinical work with the couple should include a careful evaluation of such traps and the potential breakdown or dysfunction inherent in each one, and a decision as to whether or not to attempt therapeutic penetration into such collusive agreements even before the couple complain directly about their arrangement.     

The type a behavior pattern and the need to prove oneself: A correlational study

This study set out to investigate the relationship between the Type A behavior pattern, the need for approval, and the need to prove oneself. One hundred and two subjects completed four questionnaires: two measuring A-type behavior, one social desirability, and one—especially devised for this study—the belief in the need to prove oneself consistently. Results showed that Type A’s have significantly lower needs for approval than Type B’s, yet appear to show considerably greater interest in comparing their achievements with others. It seems that Type A’s do not have any special need to prove their worth to others, but that they must constantly prove themselves to themselves. Limitations of this preliminary study are discussed.