Breathing life into family processes: introduction to the special issue on families and asthma

This introduction to the special issue dedicated to families and asthma proposes that the study of asthma highlights general systems topics such as integration of individual needs into the group, developmental trajectories of risk and resilience, supportive and destructive patterns of interaction, and the cultural adaptation of family therapy. It briefly introduces papers in the special issue and concludes that asthma can serve as an exemplar in the study of family health due to its comorbidity with mental health problems, potential to affect multiple members of the family, disproportionate influence on low-income and minority families, and multiple avenues for intervention.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

Testing the Biobehavioral Family Model in pediatric asthma: pathways of effect

This study uses a laboratory-based multiinformant, multimethod approach to test the hypothesis that a negative family emotional climate (NFEC) contributes to asthma disease severity by way of child depressive symptoms, and that parent-child relational insecurity mediates the effect. Children with asthma (n = 199; aged 7-17; 55% male) reported parental conflict, parent-child relational security, and depressive symptoms. Parent(s) reported demographics, asthma history, and symptoms. Asthma diagnosis was confirmed by clinical evaluation and pulmonary function tests, with disease severity rated by an asthma clinician according to NHLBI guidelines. Family interactions were evoked using the Family Process Assessment Protocol, and rated using the Iowa Family Interaction Rating Scales. Path analysis indicated a good fit of data to the hypothesized model (chi2[1] = .11, p =.74, NFI = .99, RMSEA = .00). Observed NFEC predicted child depression (beta = .19, p < .01), which predicted asthma disease severity beta = .23, p < .01). Relational security inversely predicted depressive symptoms (p = -.40, p < .001), and was not a mediator as predicted, but rather an independent contributor. The findings are consistent with the Biobehavioral Family Model, which suggests a psychobiologic influence of specific family relational processes on asthma disease severity by way of child depressive symptoms.     

Spirituality as a Resiliency Quality in Xhosa-speaking Families in South Africa

The purpose of this qualitative study was to explore spirituality as a characteristic of family resilience in Xhosa-speaking families in South Africa. A parent, and in some cases an adolescent, represented each of the 51 families that participated. Participants were expected to respond to three open-ended questions regarding their family and identify factors or strengths that had recently helped their family. The results indicate that spirituality is an important coping resource. The core theme of spirituality consists of six related categories that facilitated the successful adaptation of the participating families after a crisis. These categories are Gifts from God; Guidance; God's Works; God's Plan; Prayer; and Faith.     

Gender differences in severity of writing and reading disabilities

Gender differences in mean level of reading and writing skills were examined in 122 children (80 boys and 42 girls) and 200 adults (115 fathers and 85 mothers) who showed behavioral markers of dyslexia in a family genetics study. Gender differences were found in writing and replicated prior results for typically developing children: Boys and men were more impaired in handwriting and composing than were girls and women, but men, who were more impaired in those writing skills, were also more impaired in spelling than women. Men were more impaired than women in accuracy and rate of reading passages orally, but boys were not more impaired than girls on any of the reading measures. Males were consistently more impaired than females in orthographic skills, which may be the source of gender differences in writing, but not motor skills. Population-based studies that report gender differences in reading in children with dyslexia may be confounding reading and writing disorders—the latter being the true source of gender differences in both children and adults with dyslexia.     

The Role of Family Functioning in Bipolar Disorder in Families

Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured interviews. Parent report on the Family Assessment Device and the Conflict Behavior Questionnaire measured family functioning and conflict, respectively. Results revealed a small but significant indirect pathway from parental diagnosis of mood disorder to child bipolar disorder through impaired family functioning, via increased family conflict. Parental mood disorders were also significantly related to other negative outcomes in children, including unipolar depression and oppositional defiant disorder. Associations between parent diagnoses and family functioning changed depending on youth age, but not youth sex.     

“Eat your Hamburger!”—“No, I don’t Want to!” Argumentation and Argumentative Development in the Context of Dinner Conversation in Twenty Swedish Families

The aim of the present study was to analyse family dinners as context of argumentation and argumentative development by using a context-sensitive model of basic argumentative structures in every day conversations. The data consisted of 40 argumentative sequences in dinner conversations in twenty Swedish families with children aged 7 to 17 years. The families were divided in two groups depending on the children's ages (10–11 years with younger siblings and 10–12 years with older siblings). The model revealed characteristic structures of argumentation appearing as co-text and suggested differences between family groups depending on contextual factors such as age of the children. The groups of older children produced longer argumentative sequences, more exchanges per sequence and higher rate of turns. The older children also engaged in non-instrumental deliberations and disputations significantly more often and they performed more elaborated expansions (through a higher quantity of backing arguments). The groups of younger children on the other hand were more often involved in negotiations on topics relevant in the immediate context. Less expected was, however, the lack of more complex and varied arguments, even in the groups of older children.     

Perceptions of Family Relationship Factors and Depressive Symptoms in Adolescents: What Roles Do Parents and Gender Play?

The association of adolescents’ perceptions of family relationships and adolescent depressive symptoms was investigated using a sample of 2,918 youth participating in the National Longitudinal Survey of Youth 1997. Boys showed fewer depressive symptoms than girls, as hypothesized. In general, adolescents’ perceptions of family relationships were negatively related to depressive symptoms. Mother support of father predicted depressive symptoms for girls only, whereas father support of mother predicted depressive symptoms for boys only. These findings contradict previous research that suggested family functioning is more related to outcomes of adolescent girls than boys. Suggestions for future research and implications for marital and family therapists are discussed.     

人格特质、家庭环境对中学生道德判断能力的影响

以855名中学生为被试,采用路径分析等实证方法构建了个体差异变量人格特质、社会环境类因素家庭环境对道德判断能力影响的关系模型,揭示了人格特质、家庭环境各维度对中学生道德判断能力发展的直接和间接影响。当前中学生的人格特质对道德判断能力发展的总影响效应为正,家庭环境对道德判断能力发展的总影响效应为负。人格特质和家庭环境是一个整体,还应从综合的角度,用发展和系统的眼光看待其对道德判断能力的影响。     

家庭环境与高中生发展:自主的中介作用及其性别差异

从浙江省三所全日制高中选取348名高一到高三的学生为被试, 采用集体上机填答的方式实施问卷调查, 考察家庭环境对高中生发展的影响及作用机制, 探讨自主的中介作用及其性别差异。使用描述检验、相关分析和结构方程模型等方法, 结果发现:(1)男生的情感自主显著高于女生, 感知到的家庭亲密度水平显著低于女生;(2)家庭环境和自主与积极发展呈显著正相关, 与消极发展呈显著负相关, 积极发展与消极发展呈显著负相关;(3)家庭环境对积极发展有显著的正向预测作用, 对消极发展有显著的负向预测作用, 且对积极发展的预测作用显著高于消极发展;(4)总体上, 自主在家庭环境和高中生积极、消极发展的关系中起显著的中介作用;自主在家庭环境和积极发展间的中介作用在男生和女生样本中均达到显著水平, 而在家庭环境和消极发展间的中介作用在男生样本中为完全中介, 在女生样本中不显著。研究结果为从家庭角度促进高中生的积极发展、降低消极发展的可能性提供了依据。