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A cross-cultural study of major depression and family functioning.

Patterns of family functioning in families with a depressed member from two cultures (North America and Hungary) were compared. In both cultural settings, families with a depressed member reported poorer family functioning than the control families. Comparisons between the two depressed groups, however, showed that the response to family dysfunction by the two cultures differed. While depressed families in Hungary reported difficulties in setting family rules and boundaries, those in North America experienced impaired functioning in solving problems, communicating, being involved with each other, and in overall functioning. These results are discussed in terms of the interplay between culture, depression and family functioning.

Adult

Parent and adolescent perceptions of family functioning: a comparison of clinic and non-clinic families.

In this paper two studies are reported which compare (a) the perceptions of family functioning held by clinic and non-clinic adolescents, and (b) the perceptions of family functioning held by adolescents and their mothers in clinic and non-clinic families. In Study 1, matched group of clinic and non-clinic adolescents were compared on their responses to a 30-item scale (ICPS) designed to measure three factors of family functioning: Intimacy (high vs. low), Parenting Style (democratic vs. controlled) and Conflict (high vs. low). Clinic and non-clinic adolescents were also compared on their responses to a multi-dimensional measure of adolescent self-concept. Although there was little difference between the two groups of adolescents in terms of their perceptions of family functioning, there were strong relationships between the self-concept variables and the family functioning variables. In Study 2, comparisons were made between the perceptions of family functioning held by mothers and adolescents for both clinical and non-clinic families. There were no differences between the two groups of adolescents in terms of their perceptions of family functioning, although there were clear differences between the two groups of mothers. In addition, clinic adolescents and their mothers did not differ in their perceptions of the family, whereas adolescents in the non-clinic group saw their families significantly as less intimate and more conflicted than did their mothers.

Adolescent

The relationship of pretreatment family functioning to drinking behavior during follow-up by alcoholic patients.

The relationship of alcoholics' perceptions of the pretreatment functioning of their families to drinking outcomes during an 18-month follow-up was examined. Family functioning was hypothesized to be predictive of drinking behavior, particularly in subjects with low assertion of autonomy scores. These individuals report greater dependency and attachment, and therefore might be more affected by the state of important relationships. The results indicated that with low autonomy male alcoholics, greater family dysfunction predicted significantly fewer days abstinent during Months 1-6 and 13-18 and more severe drinking episodes during the first year of the follow-up. In the high autonomy males, family dysfunction was unrelated to subsequent drinking behavior. In women, on the other hand, greater family dysfunction predicted more days abstinent in those high in autonomy and was unrelated to the drinking behavior of those low in autonomy. Implications for patient-treatment matching, differences between male and female alcoholics, and the need for additional studies of family functioning and drinking behavior in women are discussed.

Adult

Families at risk of child maltreatment: entry-level characteristics and growth in family functioning during treatment.

Research suggests that perinatal screening and early intervention may reduce the incidence of maltreatment and improve the parenting in at-risk families. The question of whether families with different sets of entry-level characteristics differ in the way that they respond to intervention is asked in this paper. We investigated whether entry-level family functioning and family problems had an impact on length of time in treatment and the improvement or deterioration of family functioning over time. In our analyses, we used entry-level characteristics to classify families into five homogeneous groups--situationally stressed, chronically stressed, emotionally stressed, multirisk, and violent multirisk--and we found that treatment duration and rate of change in family functioning over time differed in clinically important ways across these groups. Our findings suggest that treatment is likely to be successful in stabilizing and slowly improving the family functioning of the majority of families at risk of child maltreatment.

Adolescent

Family functioning when children have cystic fibrosis.

The purpose of this study was to compare family functioning between 32 mothers with a child who had been diagnosed with cystic fibrosis (Group 1) and 32 mothers with a child who did not have cystic fibrosis (Group 2). The children's ages ranged from 4 months to 3 years. The mothers' perceptions of their family's functioning was measured by the Feetham Family Functioning Survey. There were no significant differences found between the groups on the total score of the Feetham Family Functioning Survey. Both groups of mothers reported that they were quite satisfied with their family functioning.

Adaptation, Psychological

Families of young children with handicaps: parental stress and family functioning.

The association of the presence of a child with handicaps and parental stress and family dysfunctioning was examined. Fifty-five families with young children with handicaps were compared with a matched group of families of children without handicaps on the variables of parental stress and family functioning. Results of family psychological measures suggest that families may be resilient in adapting to the demands of raising a child with handicaps. Although families of such children appeared to have high degrees of stress, they differed only minimally from other families in their family functioning. These results reinforce the need for family intervention to alleviate parental stress and for individualized programs emphasizing family strengths and idiosyncratic attributes.

Adaptation, Psychological

Predictors of family functioning one year following traumatic brain injury in children.

This study examined changes in family functioning and predictors of family outcome during the year following traumatic brain injury (TBI). The families of 94 children with TBI (mild = 50, moderate = 25, severe = 19), ages six to 15, were consecutively enrolled from two regional medical centers. Family interview ratings and standard measures of family and child functioning were completed three weeks after injury (measuring preinjury status), as well as three and 12 months. Two-thirds of families had moderate to good preinjury global functioning and coping resources, but more than half exhibited high levels of stress and at-risk family relationships. No significant preinjury differences by injury severity were seen on any measure. Whereas few changes in family functioning were observed over the year in the mild or moderate groups, greater deterioration occurred in the severe group. From one third to one half noted moderate to severe strain in 13 problem areas often seen in individuals with TBI. Preinjury family global functioning, however, was more strongly predictive of 12-month family functioning (R2 = .38 to .68) than was injury severity (R2 = .05 to .09). In four out of five outcome areas assessed at 12 months, preinjury status in each area was the strongest single predictor. Preinjury coping was the best predictor of stress. Families at risk can be identified and need ongoing support for optimal functioning.

Adaptation, Psychological

Social relationships and health: the relative roles of family functioning and social support.

The associations between social relationships and health have been examined using two major research traditions. Using a social epidemiological approach, much research has shown the beneficial effect of social supports on health and health behaviors. Family interaction research, which has grown out of a more clinical tradition, has shown the complex effects of family functioning on health, particularly mental health. No studies have examined the relative power of these two approaches in explicating the connections between social relationships and health. We hypothesized that social relationships (social support and family functioning) would exert direct and indirect (through depressive symptoms) effects on health behaviors. We also hypothesized that the effects of social relationships on health would be more powerfully explicated by family functioning than by social support. We mailed a pilot survey to a random sample of patients attending a family practice center, including questions on depressive symptoms, cardiovascular health behaviors, demographics, social support using the ISEL scale, and family functioning using the FEICS scale. FEICS is a self-report questionnaire designed to assess family emotional involvement and criticism, the media elements of family expressed emotion. Eighty-three useable responses were obtained. Regression analyses and structural modelling showed both direct and indirect statistically significant paths from social relationships to health behaviors. Family criticism was directly associated (standardized coefficient = 0.29) with depressive symptoms, and family emotional involvement was directly associated with both depressive symptoms (coefficient = 0.35) and healthy cardiovascular behaviors (coefficient = 0.32). The results support the primacy of family functioning factors in understanding the associations among social relationships, mental health, and health behaviors. The contrasting relationships between emotional involvement and depressive symptoms on the one hand and emotional involvement and health behaviors on the other suggest the need for a more complex model to understand the connections between social relationships and health.

Adult

Family functioning as a predictor of progress in substance abuse treatment.

This study tested the hypothesis that the level of family functioning is related to changes in the patient's progress while in treatment. We studied the relation of family functioning, as measured by the Family Adaptability and Cohesion Scales' (FACES II) dimensions of cohesion and adaptability, to 7 dimensions of the severity of patient drug use, as measured by the Addiction Severity index (ASI). The results indicated that family functioning, the cohesion dimension in particular, predicts severity of patient's dysfunction resulting from drug use and family and psychological problems. In particular, 28% of the variability in the ASI Drug Problems, 52% of the variability in the ASI Family Problems, and 29% of the variability in the ASI Psychological Problems were accounted for by the FACES II cohesion score. Although the study has several limitations, it supports the relevance of family factors in the treatment of drug-addicted patients.

Adaptation, Psychological

Poststroke family function: an evaluation of the family's role in rehabilitation.

Stroke affects long-term quality of life and well-being for not only the patients themselves but also their families. However, the focus of most rehabilitation programs has been on managing the acute stage of stroke and evaluating the effectiveness of short-term treatments. Families usually share in treatment, especially in the long term, and they are ultimately responsible for the patient's welfare. This article reviews the literature as it relates to the clinical problems that make rehabilitation a family issue.

Adaptation, Psychological

Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors.

Childhood cancer patients have a greater likelihood of long-term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment.

Adaptation, Psychological

[The perception of family function and psychosexual development in obese adolescents].

The interaction of psychological and social factors with family functioning and psychosexual development was studied in obese adolescents. Family functioning was evaluated using the triaxial classification of Tseng and McDermott. A total of 246 adolescents 8 to 18 years old (124 males and 122 females) were grouped in two: obese (n = 109) and non obese (n = 137). With the use of multivariate analysis it was found that the group of obese youngsters had higher rates of triangular parents-child dysfunction (p < 0.001) and more disapproval for their feeding behavior (p = 0.002); on the other hand, they considered they were more accepted in the family (p = 0.029) and felt greater concern from their parents (p = 0.004). It was concluded that the feeding behavior is interrelated with several aspects of the family psychodynamics which has an effect on the adolescents homeostasis and on his own body image perception. Those factors should be taken into consideration when the obese youngster is studied in clinical practice.

Adolescent

Family functioning during a critical illness: a systems theory perspective.

In this article the effects of critical illness on family functioning are described within a systems theory framework. As identified in the literature, family vulnerabilities and strengths that impede or support family functioning during the time a member has a critical illness are discussed. Strategies that nurses can use to assist families of critically ill patients are explored. A challenge to expand family-centered care across various settings is extended.

Adaptation, Psychological

Family therapy for Dutch drug users: the relationship between family functioning and success.

This article reports treatment outcome in families with drug problems after a family therapy intervention. An attempt is made to determine what changes occur in family functioning in the course of treatment with family therapy, and how these changes relate to prolonged abstinence and improvement in social functioning in drug misusers. The results indicate that, overall, most families, one year after the start of family therapy, changed in the predicted direction as determined by an observation instrument. Furthermore, success in treatment for the drug misuser was most likely to occur in families in which the parents communicated with each other in a predominantly negative way at the beginning of therapy, and when, in the course of therapy, a significant change occurred toward a more positive supportive manner of communicating.

Adult

Healthy family functioning: a cross-cultural appraisal.

It is increasingly recognized that rapid cultural, social, economic, and technological changes are imposing increasing stress on family structures, traditional values, and the ability to adapt to new environments in different societies. For the purposes of this paper, "healthy family functioning" is defined in terms of a family unit (however it is conceived in any given culture) effectively coping with cultural, environmental, psychosocial, and socioeconomic stresses throughout the family life cycle. While a review of international literature in the behavioural and biomedical sciences yields little data on comparative studies, there is growing awareness of the need for cooperative international research on family coping mechanisms and determinants of self-reliant communal coping behaviour, as well as more efficient utilization of already available knowledge. After consideration of methodological pitfalls of assessment procedures, there is a presentation of an evolving theory of healthy family functioning with the suggestion that studies of young married couples constitute a particularly promising vehicle for developing needed cooperative cross-cultural research.

Cross-Cultural Comparison

Family functioning and childhood accident occurrence.

The relationship between family functioning and childhood accident occurrence is examined, and family assessment is suggested as a diagnostic tool capable of identifying children prone to repetitive accidents. Implications for clinical intervention are discussed.

Accident Proneness

Family functioning in late late life.

This study of 150 individuals, 85 years and older, focused on their families and social networks. Using both structured and open-ended questions, we explored the extent to which the family functions as a source of support for the oldest old. The findings indicate that those with children are significantly more active with all relatives, most likely because children link them to grandchildren, great-grandchildren, and their relatives by marriage. For the 30 percent who are childless and unmarried, other relatives are not usually active providers of support, a finding which suggests that the principle of substitution does not operate effectively for this age group. Case studies illustrate the variations in family functioning in the support of their oldest members.

Aged

Family functioning and psychiatric outcomes in children and young people with intellectual and developmental disabilities caused by rare genetic mutations.

BACKGROUND: A range of rare chromosomal micro-deletions or -duplications (Copy Number Variants - CNVs) are associated with high risk of neurodevelopmental and mental health conditions (ND-CNVs). There is great individual variability in outcomes, but we lack insights into the contributing social factors, including family functioning. METHODS: Caregivers of 598 children and young people (CYP) with a range of 16 ND-CNVs and 222 siblings without ND-CNVs (controls) completed questionnaires on overall family climate (cohesion and conflict) as well as caregiver-CYP relationship warmth and hostility and took part in a research diagnostic interview about CYPs' psychiatric symptoms. CYPs' intelligence quotient (IQ) was also measured. RESULTS: Comparisons with published data from neurotypical families indicated that families affected by ND-CNVs are characterised by higher family cohesion and conflict as well as lower caregiver-CYP warmth and hostility. Symptoms of oppositional defiant disorder reduced more steeply in CYP with ND-CNVs compared to controls with increasing family cohesion (interaction effect: &#x3b2; = -0.14, p = 4.65 &#xd7; 10-2). In contrast, they rose more steeply with increasing family conflict (interaction effect: &#x3b2; = 0.18, p = 1.05 &#xd7; 10-2). Furthermore, symptoms of mood disorder increased more steeply with increased caregiver-CYP hostility in CYP with ND-CNVs (interaction effect: &#x3b2; = 0.15, p = 4.55 &#xd7; 10-2). CONCLUSIONS: Raising a CYP with a rare genetic condition is challenging. Timely access to interventions that support caregivers in fostering a positive family environment may reduce behavioural difficulties in CYP, with subsequent benefits for family functioning.

CNV