Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.     

Stepfamilies Doing Family: A Meta‐Ethnography

The present review examines how stepfamily members without a shared history co‐construct a shared family identity and what family processes are relevant in this stepfamily formation. Three databases (Web of Science, PsycInfo, and ProQuest) were systematically searched, resulting in 20 included qualitative studies. The meta‐ethnography approach of Noblit and Hare allowed synthesizing these qualitative studies and constructing a comprehensive framework of stepfamilies doing family. Three interdependent family tasks were identified: (a) honoring the past, (b) marking the present, and (c) investing in the future. Stepfamily members’ experiences of these family tasks are strongly affected by the dominant societal perspectives and characterized by an underlying dialectical tension between wanting to be like a first‐time family and feeling the differences in their family structure at the same time. These findings clearly demonstrate the family work that all stepfamily members undertake and provide a broader context for interpreting stepfamilies’ co‐construction of a new family identity.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

试探回族家庭伦理谚语的形成及意义

本文通过对回族家庭伦理谚语内容的分析,从民俗学视角对回族家庭伦理谚语的形成及其所反映的民众观进行了探讨,认为回族家庭伦理谚语的形成主要是通过对经典的借用和转化、对相邻民族谚语的采借以及自身的创造三种方式实现的;从回族家庭伦理谚语的内容我们可以看到回族民众以父子关系为家庭本位,注重家庭成员平等关系,以健康、和谐为导向的家庭伦理观。     

Examining the relationship between family context and children’s physical activity beliefs: The role of parenting style

Objectives

Previous research studies examining parental influences on children’s physical activity (PA) have focused primarily on parents’ own PA behavior, as well as their PA-related beliefs and socially supportive behaviors. The present study, although aligned with this mainstream parental influence research, was grounded in a broader child development perspective to examine the influence of parenting style on children’s PA beliefs and quality of parent-child communication.

Method

Self-report questionnaires were administered to 173 children ranging in age from 9 to 12 years to assess their perceptions of parenting style, parent-child communication patterns, as well as their own perceptions of fitness competence, value, and goal orientation.

Results

Children’s constellation of beliefs and attitudes regarding PA as well as their perceptions of the parent-child communication process did vary as a function of the type of parenting style they perceived their parents to use. High challenge parenting style was linked to higher perceived fitness competence and value on the part of the children. High support parenting style was linked to more positive perceived parent-child communication patterns.

Conclusion

Parenting style may be a critical underlying family process variable that impacts children’s development of a positive constellation of beliefs about PA. Future work is needed to link parenting style and children’s PA beliefs to their PA behavior.     

The Development of Family Alliance From Pregnancy to Toddlerhood and Child Outcomes at 5 Years

This article presents a longitudinal study of the development of “family alliance” from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self‐reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: “high stable” (n = 19), “high to low” (n = 10), and “low stable” (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family‐level and individual‐level variables for understanding individual differences in the social and cognitive development of children.     

Self-esteem modulates attentional responses to rejection: Evidence from event-related brain potentials

Individuals with low self-esteem have been shown to exhibit an attentional bias for social rejection cues. The present study investigated whether individuals with low self-esteem would demonstrate greater reactivity to rejection-related stimuli during an attention shifting task than was exhibited by those with high self-esteem. Individuals with low self-esteem showed higher amplitude event-related potentials (ERPs) in response to rejection cues than was observed for those with high self-esteem. These results suggest that individuals with low self-esteem allocate more attentional resources to rejection cues than those with high self-esteem. Discussion will focus on the implications of these findings for understanding the connection between low self-esteem and social rejection.     

Understanding children's emotional processes and behavioral strategies in the context of marital conflict

Marital conflict is a distressing context in which children must regulate their emotion and behavior; however, the associations between the multidimensionality of conflict and children’s regulatory processes need to be examined. The current study examined differences in children’s (N = 207, mean age = 8.02 years) emotions (mad, sad, scared, and happy) and behavioral strategies to regulate conflict exposure during resolved, unresolved, escalating, and child-rearing marital conflict vignettes. Children’s cortisol levels were assessed in relation to child-rearing and resolved conflict vignettes. Anger and sadness were associated with escalating and child-rearing conflicts, fearfulness was related to escalating and unresolved conflicts, and happiness was associated with resolution. Anger was associated with children’s strategies to stop conflict, whereas sadness was associated with monitoring and avoidant strategies. Cortisol recovery moderated the link between fearfulness and behavioral regulation. These results highlight the importance of children’s emotions and regulatory processes in understanding the impact of marital conflict.     

Stability and Invariance of Psychopathic Traits from Late Adolescence to Young Adulthood

The current study examined the longitudinal stability and invariance of psychopathic traits in a large community sample of male twins from ages 17 to 23. Participants were assessed across 6 years to gauge the stability and measurement invariance of the Minnesota Temperament Inventory (MTI), a Cleckley-based measure of psychopathic personality traits, and how family functioning and externalizing behavior were linked to these traits. A latent variable approach was used to model the structure of the MTI and provide a statistical test of measurement invariance across time. The results revealed support for invariance and moderate to strong stability of the MTI factors, which showed significant associations with the external correlates in late adolescence but not early adulthood.     

Do Parent–Adolescent Discrepancies in Family Functioning Increase the Risk of Hispanic Adolescent HIV Risk Behaviors?

In the family‐based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent–adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent–adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent–adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent–adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90‐day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family‐based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families.