The effects of family composition,family health,parenting behavior and environmental stress on children's divorce adjustment

The traditional family composition model of children's divorce adjustment was compared to a family competence model. Subjects included 81 children whose parents remained married, were divorced, or were divorced and subsequently remarried. Divorced families had been separated for between 24 and 48 months. Custodial parents completed questionnaires regarding family functioning, occurrence of stressful life events, and child's psychosocial adjustment. Children completed questionnaires regarding parenting behaviors and self-esteem. A trained examiner conducted a structured diagnostic interview of the child. Multivariate analysis of covariance showed that family composition had a significant effect on the occurrence of stressful events and change in income but not children's adjustment. Hierarchical multiple regression correlations indicated the most powerful predictors of child adjustment were family competence variables which accounted for 21% of the variance in child adjustment scores. In contrast, family composition accounted for only 8% of variance in child adjustment scores. Further, hierarchical multiple regression correlations indicated that higher levels of family functioning were associated with families where parental hostility was low and parents displayed few rejecting behaviors while practicing consistent and appropriate discipline.     

The Future of Psychology in Family Medicine

Psychology has been integral to the field of family medicine since its inception as a medical specialty in the 1960s. Psychologists and other behavioral scientists contribute to family medicine in teaching clinical skills, in defining research questions, in developing research methodology, and in creating integrated physical/mental health care delivery systems. Future developments in the field of psychology in family medicine are likely to emphasize development and evaluation of screening measures which identify mental health problems in primary care, development of early intervention for those mental health problems, and more precise measurement of process and quality of care and health outcomes. Psychologists have an important role to fulfill in educating physicians on alternatives to pharmacologic and medical interventions for common presenting problems in primary care. However, current economic forces shaping the practice of medicine may work against further enhancing the efficacy of the physician in dealing with psychosocial issues. The future role of psychology in family medicine is not yet delineated, and while the move toward parity of reimbursement for mental and physical health care delivery may enhance this collaboration, there is a need to continue to evaluate how the psychological well-being of patients is influenced in the evolution of new models of care delivery.     

Whose Gene Is It? A Case Discussion About Familial Conflict over Genetic Testing for Breast Cancer

A multidisciplinary group of genetic and other professionals discuss a complex case of familial conflict over access to genetic information. One twin wishes to know the results of her deceased mother's tests for BRCA1 mutations; a second twin objects to researchers making this information available. As the case discussion unfolds, the apparent facts of this case are called into question and the lines of ethical certainty become less clear.     

Termination of Mental Health Services for Children

In this paper, we examine the termination of children's mental health services. Analyses were based on the 901 families in the Fort Bragg Evaluation Project who participated at Wave 1 and Wave 2 six months later. The project compared a full continuum of care provided at a demonstration site with traditional care at two comparison sites. The results showed that in most cases families and providers were partners in decisions to terminate treatment. About half of the clients self-terminated or were terminated solely at the discretion of the provider. Providers tended to play a more dominant role in terminating restrictive services; families played a more central role in terminating outpatient care. Regardless of initial psychopathology, children in single-headed households, whose parents were dissatisfied with services, did not expect their child to cooperate with treatment and did not expect treatment to help their child, were more likely to terminate care than others. While the Demonstration site had significantly fewer terminations, the sites did not differ with regard to the reasons for termination, who participated in termination decisions, or the factors that affected the likelihood to terminate care. Of most interest, mental health outcomes among children who had terminated all care did not vary by reasons for termination or by who participated in the termination decision.     

Separability of item and person parameters in response time models

This paper discusses two forms of separability of item and person parameters in the context of response time (RT) models. The first is separate sufficiency: the existence of sufficient statistics for the item (person) parameters that do not depend on the person (item) parameters. The second is ranking independence: the likelihood of the item (person) ranking with respect to RTs does not depend on the person (item) parameters. For each form a theorem stating sufficient conditions, is proved. The two forms of separability are shown to include several (special cases of) models from psychometric and biometric literature. Ranking independence imposes no restrictions on the general distribution form, but on its parametrization. An estimation procedure based upon ranks and pseudolikelihood theory is discussed, as well as the relation of ranking independence to the concept of double monotonicity.I am indebted to Wim van der Linden for bringing Thissen's (1983) paper to my notice, and to Martijn Berger, Frans Tan, and the anonymous reviewers for their constructive comments on earlier drafts of this paper.     

Associations Between Clinic-Referred Boys and Their Fathers on Childhood Inattention-Overactivity and Aggression Dimensions

The question asked in this study of 70 clinically referred 6- to 12-year-old boys with behavior problems was whether or not childhood inattention-overactivity and aggression are transmitted specifically from biological fathers to sons. Fathers' self-reported childhood inattention-overactivity on a retrospectively valid measure was exclusively associated with parents' ratings of their sons' current attention problems on the Mothers' Operational Measure for Sub-grouping (MOMS), the Revised Child Behavior Checklist (RCBCL), and an approximated DSM-IV inattention dimension. Fathers' self-reported childhood aggression was not associated with ratings of their sons' aggression on the MOMS or DADS (a parallel instrument for fathers), nor on DSM-III oppositional or conduct disorder dimensions, but it was exclusively associated with RCBCL ratings of sons' aggressive and delinquent behavior. None of the nonspecific correlations (father inattention-overactivity with son aggression or father aggression with son inattention-overactivity) was significant.     

Aging families: The personal, permanent group

Later life families present a very special instance of group psychotherapy with older adults. This paper describes the challenges faced by later life families, including major life events to which multiple family members must adapt, and the increasing dependency of some elderly members. A developmental framework for later life problems is offered as a therapy frame useful to families. Key aspects of therapy process with later life families are also presented. Goals, strategies, structures of therapy, and the therapist’s role are all shaped by the long and intimate history of the members of this special form of group.     

Relationship Satisfaction: Impact and Consequences for Women's Emotional Health and Treatment

This study uses feminist theory to examine the variables of relationship length and relationship satisfaction as predicators of both self-esteem and emotional functioning for women. Using a national sample of data gathered from 1,257 female survey respondents this study found significant relationships between emotional functioning, self-esteem, and self-reported relationship satisfaction which was supported by regression testing and path analysis. In addition, a significant negative relationship was noted between a woman's self-esteem and her with-holding of verbalized displeasure or disagreement with her partner. Implications for women in therapy were discussed.     

Family Secrets: The Case of the Patient Kept in the Dark

The author examines the position of a child from whom important matters in his or her own life or key events in the family have been kept secret, outlines criteria by which the decision whether or not to unveil the secret should be made, and urges colleagues to gather more data and examine further family secrets.