What Children Feel About Their First Encounter with Child and Adolescent Psychiatry

The first meeting in psychotherapeutic and psychosocial work, has a big impact on the continuation. It is a less explored research field. Children’s “voices” tend to come in the back-ground in family therapy and other settings. In a project at CAP (Child and Adolescent Psychiatry) the children’s views were collected in interviews with parents and therapists present. The grounded theory analysis process was used. The children addressed the importance of the therapist’s actions and positions in helping them to be able to communicate and to be in a dialogue. To be accepted and allowed to express feelings was important, and so was how the therapist managed to adjust to each person in the room and give space for various perspectives.     

Job’s Story and Family Health

This paper examines the book of Job for encoded psychological meaning. Its main conclusion is that the story imagery expresses a need to rectify fatherly and parental oblivion for a child who is the object of the destructive envy of a sibling. A family dynamic is constructed from the story’s repeated emphasis of Job’s blamelessness and the story’s position that Satan both proposes and causes Job’s sufferings. The emergent family model sees Job as representing a son, Satan an envious rival, and God a father or parent(s). This paper proposes that Job’s story may be reactive to a period where male authority was at risk of becoming excessive, threatening family and community health.

The family career development project in Chinese Canadian families

Based on an action-theoretical conceptualization, this research examined the family career development project in Chinese Canadian families. Six families, each composed of a parent and adolescent, participated in a videotaped conversation to determine a family career development project that was subsequently monitored over a 6-month period and followed up with a second videotaped conversation. The further analysis of these data from a larger data set of 20 Chinese Canadian and European Canadian families resulted in the delineation of several properties of the career development project in Chinese Canadian families, including the importance of the parental agenda, the adolescent’s involvement, parental communication of convincing reasoning, and the adolescent’s withholding and withdrawing response. The findings also indicated that a family career development was central to other higher order projects in the family, including the relationship and cultural projects. The data supported the understanding of project as joint goal-directed action over time and as the basis on which career development influence was organized in these families.     

Childhood and adolescent predictors of early adult career pathways

Individual and contextual factors in childhood and adolescence that were hypothesized to contribute to career pathways were examined in a prospective study. Four career pathway groups were distinguished in a sample of 202 at-risk men (23-24 years of age); namely, young men with long-term unemployment, short-term unemployment, full employment, or a college education. Measures of educational attainment, family and peer characteristics, and personal adjustment during childhood and adolescence were used to determine if they would predict early adult career pathways. Findings indicated that the long-term unemployed young men, overall, showed the poorest levels of educational attainment, family and peer characteristics, and personal adjustment during childhood and adolescence.The most important predictors of differing career pathways were educational attainment, arrests, and mental health problems. Implications of the findings for conceptualizing the school-to-work transition within an integrative framework are discussed.     

Family Members' Retrospective Perceptions of Intrafamilial Relationships

Parents and daughters in 21 families of women with borderline personality disorder (BPD), 23 women with restricting anorexia nervosa (AN), and 25 women without clinical histories (NC) responded to the Parental Bonding Instrument (PBI) and the Beavers Self-Report Family Inventory (SFI). On the PBI, BPD daughters' perceptions differed from both their parents' whereas AN daughters' perceptions differed from their mothers'. On the SFI, both groups reported less family health than their parents. On both instruments, nonclinical daughters' perceptions were congruent with the parents'. These findings have implications for researchers and therapists for integrating and utilizing the varying perceptions of family members.     

Health-Related Quality of Life in a National Sample of Caregivers: Findings from the Behavioral Risk Factor Surveillance System

Purpose Recent national public health agendas, such as Healthy People 2010, call for improved public health surveillance and health promotion programs for people with disabilities and their caregivers. The goal of this study was to understand the public health impact of caregiving on health-related quality of life (HRQoL) using population-level data. Design & Methods A cross-sectional study design was used. 184,450 adults surveyed during the 2000 national Behavioral Risk Factor Surveillance System survey formed the sample. Binary logistic regression models ascertained differences between caregivers and non-caregivers in reporting reduced (“fair” or “poor”) health. Ordinary least squares regression (OLS) and multinomial logistic regression models examined the influence of caregiving status on HRQoL, measured as categories of healthy days reported in the last 30 days and the number of days reported as physical and mental health not good in the last 30 days. Results Sixteen percent (16%) of the survey respondents were caregivers. There was an interaction effect between caregiving status and age of the caregiver. In the fully adjusted models, caregivers <55 years old had a 35% increased risk of having fair or poor health (odds ratio [OR] = 1.35, 95% confidence interval [CI] 1.28, 1.43) as compared to non-caregivers in that age group, while caregivers 55 years and older had a 3% decreased risk in having fair or poor health (OR = 0.97, 95% confidence interval [CI] 0.92, 1.03) compared to non-caregivers of the same age. In the adjusted models that examined the association of caregiving and healthy days, younger caregivers similarly showed larger deficits in both mental and physical HRQoL compared to older caregivers. For example combining mental and physical days, caregivers <55 had 1.44 fewer healthy days (β = −1.44, standard error (SE) = 0.07), while caregivers 55+ had 0.55 fewer days *β = −0.55, standard error (SE) = 0.13 (compared to non-caregivers in their respective age groups). Implications With increasing population age and the projected increase in caregivers, it is important that we understand the social and public health burden of caregiving and begin to identify interventions to sustain the HRQoL of caregivers. We found that caregivers have a slight to modest decline in HRQoL compared to non-caregivers, and that caregiving affects the HRQoL of younger adults more than older adults. Further research at the population level as to the type and level of burden of caregiving is needed.     

Benefits and Changes for Family to Family Graduates

Family members of people with serious mental illnesses (SMI) need information and support to cope with the considerable stresses they experience. The Family to Family Education Program (FtF) is a structured, peer-led, 12-week information and support self-help class for such individuals. Previous research by Dixon et al. (2004) shows reduced subjective burden and increased empowerment among graduates. The present study sought to understand what processes take place during FtF participation that might lead to these benefits, as a first step in building a conceptual model of how FtF causes its effects, using semi-structured interviews with 31 FtF graduates. Qualitative data analysis suggested that new factual and emotional information from FtF shifts interviewees' understanding of their situation and that skills acquired through FtF then allow participants to incorporate these new perspectives into more adaptive behaviors. These changes led to both proximal and distal benefits for the FtF participants interviewed. The results are discussed in the context of self-help, stress-and-coping, and trauma recovery theories.     

A multidimensional, multilevel examination of mother and father involvement among culturally diverse Head Start families

In this study we examined the relationships between family demographics and level of satisfaction with school contact as possible determinants of multiple dimensions of family involvement in early childhood education. Participants included 171 urban, Head Start parents (108 mothers and 63 fathers). Results revealed that for mothers, having less than a high school education was negatively associated with levels of home-school conferencing. For fathers, primary language spoken in the home was associated with both levels of home-school conferencing and school-based involvement, with Polish- and Spanish-speaking fathers participating less compared with their English-speaking counterparts. In addition, fathers of boys reported higher levels of home-school conferencing. Involvement at school was significantly associated with level of satisfaction with school contact for both mothers and fathers. Multilevel analyses revealed parent gender and satisfaction as the most salient predictors of involvement at the level of the family. Implications for future research, as well as family involvement practice and policy, are discussed.     

Links Between Life Course Trajectories of Family Dysfunction and Anxiety During Middle Childhood

Using data from three waves of a large Canadian data set, we examine the relationship between two middle childhood trajectory variables, family dysfunction and anxiety. We draw upon family systems theory and developmental psychopathology, while attempting to expand their boundaries by capitalizing on the strengths within both approaches. Our data treatment strategy, guided by the life course analytical framework, included separate multivariate logits to examine this relationship, with and without the extent to, which selected explanatory risk variables predicted belonging to the highest family dysfunction trajectory. We also explored possible interactions between anxiety and explanatory risk variables. Supporting our hypothesis, a prolonged duration of high doses of family dysfunction was associated with the most extreme developmental trajectories of anxious behavior during middle childhood for both boys and girls. This relationship prevailed above and beyond the influence of other correlates of family dysfunction such as marital transition, socioeconomic status, family size, and depressive symptoms experienced by the informant (mostly mothers). Specific details regarding the sample, characteristics of measures, and unspecified estimates and their standard errors per data source are available from the first author in the form of tables and figures.     

Ten years of longitudinal research on U.S. adolescent sexual behavior: Developmental correlates of sexual intercourse,and the importance of age,gender and ethnic background

We integrated findings from 35 recent, longitudinal studies of the onset of heterosexual intercourse. Correlates of adolescent sexual intercourse onset, whether in early (before age 16) or middle (ages 16–18) adolescence, included living with other than two biological parents, being less monitored by parents, having more advanced physical maturity and more involvement in dating behavior, and having more permissive attitudes toward sex. When studies were organized by age of participants, the onset of intercourse was more strongly associated with alcohol use, delinquency, school problems and (for girls) depressive symptoms in Early studies (sexual intercourse by age 15 or before only) than was found in studies classified as Middle (assessment of sexual intercourse up to age 18) or Late (knowledge of those who delayed until after age 18). Although more research is needed, additional factors were associated with delaying first sexual intercourse until after age 18, including religious attitudes and anxiety, with some factors more relevant for girls and some more applicable to boys. In total, the evidence suggests there are many similarities, but also some important differences, in the correlates associated with early versus middle versus later onset of sexual intercourse. This seems to signify more than one pathway (set of distal and proximal correlates) associated with sexual behavior during adolescence that should be tested in future research. Throughout the review, we highlight differences in the correlates of girls’ versus boys’ sexual intercourse and how race/ethnicity moderates associations. These gender and racial/ethnic differences were found largely in analyses of family processes, school and religion, and parent education. We end by summarizing several priority areas for future research.