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PubMed1992

The California Family Health Project: IV. Family structure/organization and adult health.

This research explores the relationships between each of four "domains" of family life and the health of husbands and wives in a community-based sample of 225 families. In this article we report the association between Family Structure/Organization and adult Health. This family domain refers to the architecture of the family or the structural frame of roles and rules within which the family operates. Interrelationships among 13 self-reported, family Structure/Organization scales are described, using principle components analysis (PCA) and multidimensional scaling analysis (MDS). Derived, joint-spouse or couple Structure/Organization variables also were created using inter-battery factor analysis. The PCA yielded a poor solution, whereas the MDS yielded a good two-dimensional solution, which roughly displayed the scales in a circular pattern for both husbands and wives. The analyses indicated that no single dimension or set of separate subdimensions adequately described the Structure/Organization variables. All 13 scales than were associated with a battery of 14 adult health scales for husbands and wives separately, using canonical correlation. Different aspects of family Structure/Organization were correlated with health for husbands and wives: Organized Cohesiveness, Sex Role Traditionalism, Role Flexibility and Shared Roles for husbands; and Organized Cohesiveness and Differentiated Sharing for wives. Different patterns of health scores also emerged by gender, with behavioral indicators, such as Smoking and Drinking, more salient for husbands, and mood indicators, such as Anxiety and Depression, more salient for wives.

Adult↗
PubMed1998

Trainees' conjugal family experience, current intergenerational family relationships, and the therapeutic alliance.

This study examines the relationship between trainees' conjugal family experience, current intergenerational family relationships, and the client's perception of the therapeutic alliance. Participants were 74 first practicum family therapy trainees, representing two family therapy programs, and 90 clients. Results indicated a moderately significant relationship between conjugal family experience and trainees' reported intergenerational intimacy with parents. Additionally, clients whose therapists had conjugal family experience reported a slightly more favorable therapeutic alliance than clients whose therapists did not have conjugal family experience. Additionally, trainees with conjugal family experience reported more current intimacy and individuation than nonconjugal trainees and felt less intimidated by their parents.

Adult↗
PubMed1998

Muslim families and family therapy.

Muslim immigrant families living in the United States may well come to the attention of mental health professionals. This article examines the applicability of the Anglo-American models of family therapy to Muslim immigrant families. The most significant differences in value systems between the Muslim and Anglo-American cultures is Muslim families' preference for greater connectedness, a less flexible and more hierarchical family structure, and an implicit communication style. Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural differences. However, the preferred directions of change for Muslim families need to be integrated into the assessment and goals for family therapy.

Attitude to Health↗
PubMed1985

Family interaction patterns among Japanese-American and Caucasian families in Hawaii.

The authors compared the family interaction patterns of Japanese-American and Caucasian families in Hawaii by rating videotapes of structured family interactions. There were significant differences between the two groups in many aspects of family interaction, such as power, coalition, closeness, negotiation, clarity of self-disclosure, responsibility, invasiveness, affect, and empathy. The differences in family interaction could be explained by the cultural differences between the two groups and indicate that profiles of healthy families differ between distinct cultures, and there is a need to establish a culturally relevant family interaction profile; otherwise normal interactions in families outside the mainstream could be misinterpreted as pathological.

Adolescent↗
PubMed1999

Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-incidence autism families.

OBJECTIVE: Several studies have shown familial aggregation of some axis I psychiatric disorders in families ascertained through a single autistic proband. In this study the authors examined the rate of axis I psychiatric disorders in nonautistic relatives from multiple-incidence autism families and the possible relationship of these disorders to the broad autism phenotype. METHOD: The rates of axis I psychiatric disorders, assessed by using semistructured and family history interviews, were compared in parents, grandparents, and aunts and uncles ascertained through 25 families of multiple-incidence autism probands and 30 families of probands with Down's syndrome. The possible association between selected psychiatric disorders and the broad autism phenotype, assessed directly through semistructured interviews and observational rating measures, was also examined in the two groups of parents. RESULTS: The parents of the autistic probands had significantly higher rates of major depressive disorder and social phobia than the parents of the Down's syndrome probands. The high rate of depression in the parents of the autistic probands was consistent with the high rates of depression and anxiety detected in the grandparents and aunts and uncles in the autism families by family history. There was no evidence of an association, within individuals, between either depression or social phobia and the broad autism phenotype. CONCLUSIONS: Relatives of autistic individuals have high rates of major depression and social phobia that are not associated with the broad autism phenotype and cannot be explained by the increased stress associated with raising an autistic child. Alternative mechanisms and the scientific and clinical implications of these findings are discussed.

Adolescent↗
PubMed2002

Features in families and family relationships.

Standardized assessment of family features is not used routinely, although these factors may play an important role in the course of children's psychological disorders. The present study investigated the association among relationships within the families of 115 healthy children (M=8.2 yr., SD=2.13; 70 boys, 45 girls). 115 mothers and fathers were asked to complete a standardized questionnaire assessing the family features (Familienklima-Testsystem by Schneewind, et al.) and another asking for their estimation of emotional relationships of the members of the family (Subjektives Familianbild-Test System by Mattejat). Analysis showed that the parents' ratings indicated significantly more empathic fathers as well as significantly more autonomous mothers in well-organized, conflict-free families. Our results indicate an association between families' organization and measured scores for fathers' empathy and mothers' autonomy. Sufficient intrafamilial communication is associated with roles of the parents within the family. Psychotherapeutic interventions might focus on the families' organization.

Child↗
PubMed2000

Can addressing family relationships improve outcomes in chronic disease? Report of the National Working Group on Family-Based Interventions in Chronic Disease.

The management of patients with chronic disease constitutes the largest single cost to the health care system in the United States. New approaches and methods are needed to reduce preventable complications and to enhance the health and well-being of patients with chronic disease and their families. Interventions that target the family setting in which disease management takes place have emerged as an alternative to traditional strategies that focus only on the individual patient or that consider the family only as a peripheral source of positive or negative social support. In this approach, the educational, relational, and personal needs of all family members are emphasized. Data reviewed by the National Working Group on Family-Based Interventions in Chronic Disease identified potential mechanisms by which the relational context of the family affects disease management and how characteristics of family relationships serve as risk or protective factors. In this paper we describe the major forms of family-based interventions, review the results of selected clinical trials, and present applications for clinical practice. The data suggest that approaches to the management of chronic disease should be expanded to include the broader relational context in which disease management takes place. Although it adds complexity to clinical intervention, this approach increases clinical flexibility, addresses the important players in disease management, and accounts for a significant number of risk and protective factors that affect outcome.

Adolescent↗
PubMed2001

Noninherited maternal antigens do not increase the susceptibility for familial rheumatoid arthritis. European Consortium on Rheumatoid Arthritis Families (ECRAF).

OBJECTIVE: It has been proposed that noninherited maternal HLA-DR antigens (NIMA) might play a role in the susceptibility for rheumatoid arthritis (RA). This hypothesis has not been thoroughly tested in patients with familial RA, in whom genetic factors, either inherited or not, might have stronger influence than in patients with sporadic RA. We investigated the NIMA hypothesis in a large cohort of European patients with familial RA. METHODS: The distribution of NIMA, noninherited paternal antigens (NIPA), and inherited HLA-DR antigens was assessed in patients with familial RA from all family sets collected from 1996 onwards by the ECRAF. HLA-DRB1 oligotyping from patients and all available nonaffected siblings and parents was carried out. Familial RA was defined by the presence of at least 2 affected first-degree relatives in the same family. The frequencies of HLA-DR NIMA and NIPA were compared using odds ratios after stratification for HLA-DR*04, *0401, and/or *0404 and shared epitope (SE) status. NIMA/NIPA that coincided with inherited parental HLA-DR antigens were considered redundant and were excluded from analysis. RESULTS: NIMA and NIPA could be analyzed in 165 RA patients with familial RA and 84 nonaffected siblings. Patients were predominantly female, rheumatoid factor positive, and had erosive disease (81, 75, and 84%, respectively). Possession of HLA-DR*04 and *0401/*0404 alleles tended be more frequent in patients than in nonaffected siblings but this did not reach statistical significance. SE possession was similar in patients and healthy siblings, although the former had a double dose SE more often (37.6 vs 17.8%; p = 0.002). Transmission of SE encoding alleles from parents to offspring was skewed only in patients [OR (95% CI) 3.56 (2.55-4.95) vs 1.16 (0.75-1.79) in nonaffected siblings]. Using the NIPA as control, the frequencies of HLA-DRB1*04, *0401/*0404, and SE positive NIMA were not increased in patients lacking these susceptibility alleles. The frequencies of NIMA encoding susceptibility alleles in DR*04 and *0401/*0404 negative patients were lower than in nonaffected siblings. CONCLUSION: Our results corroborate the association between RA and inherited SE alleles and do not support a role for noninherited HLA-DR maternal antigens in the susceptibility for familial RA.

Adult↗
PubMed2001

Family lives and friendships: the perspectives of children in step-, single-parent, and nonstep families.

Children's reports on their experiences in different family settings (stepfamilies, single-parent families, and intact families), their contact with friends, and the quality of their friendships were studied with data from 238 children drawn from a community sample. A particular focus was on children's confiding and communication: children's recall of communication about family transitions and their current communication about stepfamily issues with family and friends. Friends were found to be key confidants. The relations between children's family lives (confiding, parent-child relationships, family activities, involvement in parental conflict, and communication about stepfamily issues) and their friendships were investigated and found to be linked to biological relatedness and family setting.

Adolescent↗
PubMed1975

Differentials in fertility, family planning practice, and family size values in South Korea, 1965-1971.

Data from five Korean national KAP surveys of currently married women, conducted between 1965 and 1971, are analyzed to determine whether differentials have emerged or are emerging between urban and rural women in three factors of crucial importance for population growth: fertility, family planning practice, and family size values. Graphics are used throughout to analyze urban-rural differentials and trends in these factors over time. In addition, two statistical tests, the sign and binomial, are applied to the differentials to provide a tabular summary of results. Part I provides background information on population growth, urbanization, the achievements of the national family planning program, and economic development in Korea since the 1950's. Part II describes both urban-rural differentials in fertility, as measured by mean parity, for married women aged 30-39 between 1966 and 1971; and urban-rural differentials in the proportions of women aged 25-39 currently practicing family planning between 1965 and 1971. Part III analyzes urban-rural differences in ideal family size and ideal number of sons, controlling for number of living children and number of living sons. Part IV attempts to evaluate the impact of the national family planning program on the fertility, family planning practice, and family size values of the rural population by examining the findings on urban-rural differentials in the context of social and economic development, viewing the program as one of a multitude of variables that can affect these factors.

Adult↗
PubMed1991

[Origin of problematic constellations in psychiatric family care. Theoretical considerations and presentation of the course of a discontinued family care episode].

Psychiatric family care is a therapeutic environment for mentally ill long-term patients that pays particular attention to the individuality of the patient, contrary to the hospitalising psychiatric clinic. The influence exercised by the host family on the positive development of the integration process is undisputed in literature, but has been hardly investigated so far in respect of its actual contents. Those who are practically engaged in family care have been discussing for some time whether successful integration is effected by "good host families" or by the special constellation that develops between the host family and the guest. The present article tries to emphasise (following a review of the literature) on the basis of a discontinued family care episode that integration into a host family is not a static affair but a highly sensitive process determined by the biography of the guest and the integration between host family and guest (or guests). The possible consequences for the care process are discussed.

Deinstitutionalization↗
PubMed1988

Families, family roles, and psychological diagnoses in primary care.

This study examined the effect of belonging to a specific family on rates and occurrence of psychological diagnoses among the family members. Data were obtained from 693 families totaling 2907 parents and children during ambulatory care visits to a prepaid health care center. Families tended to have the majority of their members either with or conversely without a psychological diagnosis. The likelihood of having a psychological diagnosis was increased by 35% if another family member had been so diagnosed. Consequently, a small (3%) proportion of families accounted for a large (25%) proportion of these diagnoses. Children whose fathers were high utilizers of general health care services, or whose parents, particularly mothers, had a psychological diagnosis, were significantly more likely to have a diagnosis in this category as well. Families in which both parents had such a diagnosis were twice as likely to have an affected child. Siblings appeared not to exert any effect on one another in this regard. Family size and birth order had no effect on the incidence of psychological diagnoses.

Adolescent↗
PubMed1981

A family data base for the family oriented medical record.

A family data base is defined along with the method for obtaining it. It can be used in its entirety to evaluate troubled families, or it can be abbreviated for intake and screening functions. Once complete, the data base is incorporated into the family oriented medical record, serving a purpose for the family analogous to that of the traditional history and physical examination for the individual. It provides for family medical and social information to be kept in one place, obviating the necessity of recording the information separately for each family member. The primary focus of the data base is psychosocial, but other problems, such as inherited or infectious disease in the family, are also included. This method has been used to teach concepts of family oriented care and to facilitate health care delivery in a variety of settings.

Aged↗
PubMed1996

Adolescent alcohol use: social determinants and the case for early family-centered prevention. Family-focused prevention of adolescent drinking.

The family plays a central role in the use of alcohol by children and adolescents, yet preventive interventions rarely focus on the family. Early drinking and much subsequent use of alcohol by children and adolescents is sanctioned and sometimes encouraged by their families. Unlike experimentation with alcohol, problem drinking is associated with low levels of family social support and with dysfunctional coping strategies of families that may lead children to use drinking as an adaptive behavior. While risk-factor research has advanced understanding of alcohol use by children and youth, the poor predictive power of individual risks has limited its contribution to successful interventions. On the other hand, protective factors, provided by relationships within and outside the family, can be preventive and health promoting. Parents influence their children's drinking through family interactions, modeling and reinforcing standards, and attitudes that children learn and use to guide their behavior in new situations. Thus, parental influences endure. This article argues that interventions to prevent alcohol abuse should be designed to help parents to carry out their parental functions. This can be accomplished by providing social support, resources, and education for parents, as well as developing extra-familial sources of social support and socialization for children and adolescents.

Adaptation, Psychological↗
PubMed1999

Family risk factors associated with adolescent pregnancy: study of a group of adolescent girls and their families in Ecuador.

PURPOSE: To identify characteristics within the family that were associated with adolescent pregnancy in a group of adolescent girls in Quito, Ecuador. METHODS: Of 135 female adolescents (12-19 years of age), 47 were pregnant and seen at the adolescent prenatal care clinic at an inner city hospital in Quito, and 88 were students from schools located within the same geographic area. Family variables were compared for pregnant and nonpregnant adolescents using chi-square, Student's t-test, and analysis of variance. RESULTS: More nonpregnant adolescents lived with their biological parents when compared with their pregnant peers (p < .002). Pregnant adolescents reported lower mother-daughter and father-daughter communication (p < .02), lesser life satisfaction and happiness in general, and more school and economic difficulties (p < .001). They were less likely to find support for their problems in or outside the family (p < .0001) and showed higher levels of depression and sexual abuse than their nonpregnant peers (68.8% vs. 34.5%, and 14.9% vs. 4.5%, respectively). Nonpregnant adolescents showed higher school performance and expectations regarding school achievement and future perspectives (p < .001). Values such as respect for others and religiosity were higher among nonpregnant adolescents (p < .0001). Parental education was lower in the families of pregnant adolescents (p < .05). Among nonpregnant adolescents, both parents worked outside the home (p < .006), whereas mothers of pregnant adolescents usually stayed at home. CONCLUSION: The current study showed that parental separation or divorce, and poor parent-daughter communication were associated with adolescent pregnancy. Families of nonpregnant adolescents had a higher educational level, and both parents worked to provide financial support to the family in an environment where family authority is shared by both parents. There were also better problem-solving strategies and parent-daughter communication, higher levels of cohesion, connectedness, and life satisfaction in general, and higher future expectations.

Adolescent↗
PubMed1991

Birth order, family size, and achievement: family structure and wage determination.

The influence of birth order and childhood family size on future achievement is discussed. Two major empirical findings are presented by the author. "First, neither birth order nor childhood family size significantly influences the level or growth rate of wages, a result that is consistent with previous research. Second, family size is both a statistically and economically significant determinant of women's employment status: women from small families work less than women from large families when they are young and more than women from large families when they are more mature." The geographical focus is on the United States.

Americas↗
PubMed1987

Attitudes towards family size and family planning among women at an antenatal clinic in Maiduguri, Nigeria.

"This report describes a family planning survey [involving 172 women] conducted at an antenatal clinic in Maiduguri, Nigeria between June and August 1984. The level of education of respondents is generally low and appears to have a negative effect on knowledge, approval, and use of family planning. Breast feeding is widespread but not many respondents practiced it as a method of family planning. While there is limited knowledge and some approval of family planning, a desire for large families continues and there is relatively little practice of family limitation. The prospects for a decrease in fertility in the near future is not encouraging."

Africa↗
PubMed1981

The family meets the hospital. Predicting the family's perception of the treatment program from its problem solving style.

A family's perception of a treatment program may determine whether ir becomes productively engaged or destructively withdrawn. A theory of family types, in conjunction with a standardized laboratory problem solving procedure, was used to predict the nature of families' shared perceptions of a psychiatric ward. The individual and shared perceptions of thirty families were determined by means of a specially designed Q-sort. Two dimensions of problem solving behavior successfully predicted significant differences between families in their shared perceptions. Configuration, or the family's capacity to derive effective solutions in the laboratory, predicted the subtlety to their perception of the ward. Coordination, or the capacity of family members to dovetail their problem solving effort with one another, predicted the family's sense of comfort and engagement in the ward setting.

Adolescent↗