The relationship between family support; pain and depression in elderly with arthritis

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.     

A pilot study of two-day cognitive-behavioral therapy for panic disorder

The present study investigated the short-term efficacy of brief, intensive cognitive-behavioral therapy (CBT) for panic disorder (PD). The treatment involved 9h of therapist contact over two consecutive days and was developed for the purpose of delivering CBT for PD to a largely rural patient population that must travel long distances to find a treatment provider. Ten patients who elected to participate in brief, intensive CBT instead of weekly CBT were recruited from routine clinical practice in a hospital-based anxiety disorders clinic. Patients were not excluded based on the presence of agoraphobia, diagnostic comorbidity, concurrent use of PRN benzodiazepine medications, or previous nonresponse to psychotherapy for PD. Assessments conducted at pre-treatment and 1-month follow-up revealed large, clinically significant reductions in PD symptoms, anxiety sensitivity, body vigilance, and anxiety and depressive symptoms. Most patients (60%) were panic-free after treatment and evidenced normative levels of symptomatology at follow-up. The present study suggests that brief, intensive treatment may be an effective means of delivering CBT for PD.     

Exploring triangulation in infancy: two contrasted cases

Two contrasted father-mother-infant interactions are observed longitudinally during trilogue play. They illustrate the contribution of recent research to the exploration of triangulation in infancy: namely, the infant's capacity to handle triangular interactions and share her affects with her two parents, and the way that this capacity is recruited in functional versus problematic alliances. It is likely that an infant under stress when interacting with one parent will protest at that parent and also at the other. Such is the case when, for example, the father acts intrusively while playing with his baby. The infant is then driven to avert and turns to the mother. The regulation of this dyadic intrusion-avoidance pattern at family level depends on the family alliance. When coparenting is supportive, the mother validates the infant's bid for help without interfering with the father. Thus, the problematic pattern is contained in the dyad, and the infant's triangular capacities remain in the service of her own developmental goals. But when coparenting is hostile-competitive, the mother ignores the infant's bid or engages with her in a way that interferes with her play with her father. In this case, the infant's triangular capacities are used to relieve the tension between the parents. The importance of tracing family process back to infancy for family therapy is discussed.     

Brief strategic family therapy: lessons learned in efficacy research and challenges to blending research and practice

In this article, we present key lessons that we have learned from (1) a long program of research on an empirically supported treatment, brief strategic family therapy (BSFT), and (2) our ongoing research and training efforts related to transporting BSFT to the front lines of practice. After briefly presenting the rationale for working with the family when addressing behavior problems and substance abuse in adolescent populations, particularly among Hispanic adolescents, we summarize key findings from our 30-year program of research. The article closes by identifying barriers to the widespread adoption of empirically supported treatments and by presenting current work within the National Institute on Drug Abuse's Clinical Trials Network that attempts to address these barriers and obstacles.     

Play with me at my speed: describing differences in the tempo of parent-infant interactions in the Lausanne Triadic Play paradigm in two cultures

The goal of the present study was to examine the tempo of triadic play in Swedish and American families through a comparison of 20 families from each culture. When infants were approximately 3 months old, families in both cultures participated in the Lausanne Triadic Play (LTP), a paradigm that facilitates the examination of the triad as a whole and an organization of its parts. All family play sessions were coded separately in Sweden and America using coding systems that had been developed in each country. Dynamics within the triadic play were compared across cultures, and also across coding systems. Results indicated that both coding systems described a distinct difference in the tempo of play between American and Swedish Families. Overall, although there were many similarities between countries, American families were found to have a faster pace in triadic play than Swedish families. This difference in tempo is explored in the data analyses and the discussion of this article.     

Neighbourhood,school and family determinants of children's aspirations in primary school

Aspirations can be important for young children as well as adolescents. However, there is little research on the determinants of aspirations in young children. We carried out this study to investigate the early contextual (neighbourhood, school and family) determinants of occupational aspirations in primary school children. Our sample comprised children from the Millennium Cohort Study who lived in England in the beginning of our study period (n = 10,086; 5,126 boys). Occupational aspirations were measured at age 7 years, while their contextual determinants were measured in the previous data sweeps, at ages 3 and 5 years. We fitted structural equation models to test the role of family and neighbourhood socio-economic status (SES) and child ethnicity in predicting aspirations both directly and via their associations with parental involvement, household chaos, school-level achievement and child cognitive ability. We found that the only significant determinants of aspirations at age 7 years were family SES and ethnicity, and only in boys. Family SES and ethnicity were also related to parental involvement, household chaos, cognitive ability and school-level achievement, but none of these factors predicted aspirations. Supplementary analysis showed that family SES was a particularly powerful determinant of the aspirations of white compared to non-white boys.     

The Effects of a Multiple Family Therapy on Adolescents with Eating Disorders: An Outcome Study

Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty‐two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI‐2), the Outcome Questionnaire 45 (OQ‐45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ‐45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.     

Family boundary characteristics,work–family conflict and life satisfaction: A moderated mediation model

Although work–family border and boundary theory suggest individuals' boundary characteristics influence their work–family relationship, it is largely unknown how boundary flexibility and permeability mutually influence work–family conflict and subsequent employee outcomes. Moreover, the existing work–family conflict research has been mainly conducted in the United States and other Western countries. To address these gaps in the work–family literature, the present study examines a moderated mediation model regarding how family boundary characteristics may influence individuals' work–family conflict and life satisfaction with a sample of 278 Chinese full‐time employees. Results showed that employees' family flexibility negatively related to their perceived work interference with family (WIF) and family interference with work (FIW), and both these two relationships were augmented by individuals' family permeability. In addition, WIF mediated the relationship between family flexibility and life satisfaction; the indirect effect of family flexibility on life satisfaction via WIF was stronger for individuals with higher family permeability. The theoretical and managerial implications of these findings are discussed.     

Resilience in Community: A Social Ecological Development Model for Young Adult Sexual Minority Women

Family support and rejection are associated with health outcomes among sexual minority women (SMW). We examined a social ecological development model among young adult SMW, testing whether identity risk factors or outness to family interacted with family rejection to predict community connectedness and collective self‐esteem. Lesbian and bisexual women (N = 843; 57 % bisexual) between the ages of 18–25 (M = 21.4; SD = 2.1) completed baseline and 12‐month online surveys. The sample identified as White (54.2 %), multiple racial backgrounds (16.6 %), African American (9.6 %) and Asian/Asian American (3.1 %); 10.2 % endorsed a Hispanic/Latina ethnicity. Rejection ranged from 18 to 41 % across family relationships. Longitudinal regression indicated that when outness to family increased, SMW in highly rejecting families demonstrated resilience by finding connections and esteem in sexual minority communities to a greater extent than did non‐rejected peers. But, when stigma concerns, concealment motivation, and other identity risk factors increased over the year, high family rejection did not impact community connectedness and SMW reported lower collective self‐esteem. Racial minority SMW reported lower community connectedness, but not lower collective self‐esteem. Families likely buffer or exacerbate societal risks for ill health. Findings highlight the protective role of LGBTQ communities and normative resilience among SMW and their families.